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Bock K, Peltzer J, Liu W, Colgrove Y, Smirnova I, Siengsukon C. Sleep quality and lymphedema in breast cancer survivors: a mixed method analysis. J Cancer Surviv 2024:10.1007/s11764-023-01516-9. [PMID: 38183577 DOI: 10.1007/s11764-023-01516-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Accepted: 12/17/2023] [Indexed: 01/08/2024]
Abstract
PURPOSE The purpose of this convergent mixed methods study was to assess the perceptions and characteristics of sleep in breast cancer survivors (BCSs) and elucidate perceptions of sleep among BCS with lymphedema. METHODS Participants were BCS with and without lymphedema. Both groups completed the Pittsburgh Sleep Quality Index (PSQI), PROMIS® Sleep Disturbance (8a short form), and wore an actigraph on their wrist to capture sleep/wake cycles for 7 days/nights while logging their sleep using a sleep diary. The coefficient of variation of sleep efficiency was calculated from the sleep diary to assess intraindividual variability. In addition, a subsample of BCS with lymphedema participated in a semi-structured qualitative interview. The qualitative data was analyzed separately, and the themes were applied to provide a more nuanced explanation of the quantitative outcomes. RESULTS The BCS with lymphedema (n=23) had a significant difference in PSQI (p=0.002), PROMIS® Sleep Disturbance (p=0.084), and sleep efficiency coefficient of variation (p=0.014) compared to BCS without lymphedema (n=23). There were no statistically significant differences between groups in the actigraphy results. BCS with lymphedema perceived that lymphedema management contributed to their sleep disturbance, further exacerbating their mind/body fatigue. CONCLUSION This study provides the foundation for future research to investigate the integration of sleep interventions with lymphedema management for holistic survivorship care for BCS with lymphedema. IMPLICATIONS FOR CANCER SURVIVORS An innovative sleep health intervention designed to consider the unique factors contributing to sleep disturbance in BCS with lymphedema will fill a gap in their post-cancer treatment quality of life.
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Affiliation(s)
- Karen Bock
- Department of Physical Therapy, Rehabilitation Science, and Athletic Training, University of Kansas Medical Center, Kansas City, KS, USA.
| | - Jill Peltzer
- School of Nursing, University of Kansas Medical Center, Kansas City, KS, USA
| | - Wen Liu
- Department of Physical Therapy, Rehabilitation Science, and Athletic Training, University of Kansas Medical Center, Kansas City, KS, USA
| | - Yvonne Colgrove
- Department of Physical Therapy, Rehabilitation Science, and Athletic Training, University of Kansas Medical Center, Kansas City, KS, USA
| | - Irina Smirnova
- Department of Physical Therapy, Rehabilitation Science, and Athletic Training, University of Kansas Medical Center, Kansas City, KS, USA
| | - Catherine Siengsukon
- Department of Physical Therapy, Rehabilitation Science, and Athletic Training, University of Kansas Medical Center, Kansas City, KS, USA
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Yarosh RA, Jackson CL, Anderson C, Nichols HB, Sandler DP. Sleep disturbances among cancer survivors. Cancer Epidemiol 2023; 87:102471. [PMID: 37837808 PMCID: PMC10873004 DOI: 10.1016/j.canep.2023.102471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 10/07/2023] [Accepted: 10/10/2023] [Indexed: 10/16/2023]
Abstract
PURPOSE We investigated sleep disturbances among cancer survivors compared to similarly aged women without cancer history. METHODS We identified 2067 women with a history of cancer other than breast or non-melanoma skin cancer at enrollment in the Sister Study, a US-wide cohort of women with a family history of breast cancer. Cancer survivors were matched with up to 5 cancer-free women (N = 9717) on age at enrollment. An index age (for covariate classification) was defined as the age at cancer diagnosis for survivors and the same age for their matched comparators. Sleep disturbances included duration, sleep medication usage, insomnia symptoms, long sleep-latency onset (≥30 min to fall asleep), frequent night awakenings (waking ≥3/night, ≥ 3 times/week), frequent napping (≥ 3 times/week), and a composite outcome of ≥ 1sleep disturbance. Multivariable linear regression (effect estimate, 95% confidence interval (CI)) and logistic regression (odds ratio, OR, 95% CI) were used for continuous and dichotomous outcomes, respectively. RESULTS At enrollment, cancer survivors were on average 13.8 years (range=0, 62) from diagnosis. After adjustment for age at enrollment and depression, diabetes, hypertension, and menopausal status prior to the index age, sleep disturbances were generally not more common among cancer survivors compared to those without cancer. However, among cancer survivors, those > 2 years from diagnosis were more likely to report ≥ 1 sleep disturbance (OR=1.44; 1.07, 1.93) compared to survivors 0-2 years from diagnosis. CONCLUSION Addressing sleep disturbances may improve well-being for cancer survivors.
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Affiliation(s)
- Rina A Yarosh
- Department of Epidemiology, UNC Gillings School of Global Public Health, Chapel Hill, NC, USA.
| | - Chandra L Jackson
- Epidemiology Branch, National Institute of Environmental Health Sciences, Durham, NC, USA; Intramural Program, National Institute on Minority Health and Health Disparities, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA.
| | - Chelsea Anderson
- Department of Epidemiology, UNC Gillings School of Global Public Health, Chapel Hill, NC, USA.
| | - Hazel B Nichols
- Department of Epidemiology, UNC Gillings School of Global Public Health, Chapel Hill, NC, USA.
| | - Dale P Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, Durham, NC, USA.
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Calvo-Schimmel A, Paul SM, Cooper BA, Shin J, Harris C, Oppegaard K, Hammer MJ, Cartwright F, Conley YP, Kober KM, Levine JD, Miaskowski C. Oncology Outpatients With Worse Anxiety and Sleep Disturbance Profiles Are at Increased Risk for a Higher Symptom Burden and Poorer Quality of Life. Cancer Nurs 2023; 46:417-431. [PMID: 35688433 PMCID: PMC9729413 DOI: 10.1097/ncc.0000000000001139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Anxiety and sleep disturbance are frequent symptoms during chemotherapy. OBJECTIVES Purposes were to identify subgroups of oncology outpatients with distinct joint anxiety and sleep disturbance profiles, as well as evaluate for differences in demographic and clinical characteristics, sleep disturbance characteristics, severity of common symptoms, and quality-of-life outcomes among these subgroups. METHODS Oncology outpatients (n = 1331) completed self-report measures of anxiety and sleep disturbance 6 times over 2 chemotherapy cycles. Latent profile analysis was done to identify subgroups of patients with distinct joint anxiety and sleep disturbance profiles. RESULTS Three profiles were identified (ie, no anxiety and low sleep disturbance (59.7%), moderate anxiety and high sleep disturbance (32.5%), high anxiety and very high sleep disturbance (7.8%)). Compared with the no anxiety and low sleep disturbance class, the other 2 classes were younger; less likely to be married; had a lower annual household income; and had childcare responsibilities. Patients in the 2 worse profiles had problems with both sleep initiation and maintenance. These patients reported higher levels of depressive symptoms, trait and state anxiety, and evening fatigue, as well as lower levels of morning and evening energy, cognitive function, and poorer quality of life. CONCLUSIONS More than 40% of patients had moderate or high levels of anxiety and high or very high levels of sleep disturbance. Modifiable risk factors associated with these profiles may be used to develop targeted interventions for 1 or both symptoms. IMPLICATIONS FOR PRACTICE Clinicians need to assess for the co-occurrence of anxiety and sleep disturbance.
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Affiliation(s)
- Alejandra Calvo-Schimmel
- Author affiliations: School of Nursing, University of California, San Francisco (Drs Calvo-Schimmel, Paul, Cooper, Kober, and Miaskowski and Mss Shin, Harris, and Oppegaard); Dana Farber Cancer Institute, Boston, Massachusetts (Dr Hammer); Department of Nursing, Mount Sinai Medical Center, New York (Dr Cartwright); School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania (Dr Conley); and School of Medicine, University of California, San Francisco (Drs Levine and Miaskowski)
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Liu S, Liu J, Su J, Zhang F. Efficacy and safety of electroacupuncture for secondary sleep disorders: A meta-analysis and systematic review. Medicine (Baltimore) 2023; 102:e34150. [PMID: 37390293 PMCID: PMC10313263 DOI: 10.1097/md.0000000000034150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Accepted: 06/08/2023] [Indexed: 07/02/2023] Open
Abstract
BACKGROUND To explore the efficacy and safety of electroacupuncture (EA) for secondary insomnia through a meta-analysis and a systematic review. METHODS The CNKI, Wanfang, VIP database, Web of Science, EMBASE, PubMed, and Cochrane Library were retrieved. The retrieval date was February 28, 2023. Two independent reviewers conducted literature screening, data extraction, and risk of bias (ROB) assessment. The revised Cochrane ROB tool was used to assess the ROB in included studies. Data analysis was performed using RevMan 5.4 software and Stata 15.0. RESULTS Thirteen randomized controlled studies were included, involving 820 patients, including 414 patients in EA group and 406 patients in the control group. Compared with the control group, EA could improve secondary insomnia overall responses (relative risk = 3.90, 95% confidence interval [CI] [1.87, 8.13], P < .001), reduce Pittsburgh Sleep Quality Index score (mean difference [MD] = -2.26, 95% CI [-4.14, -0.37], P = .02), reduce Athens Insomnia Scale score (MD = -0.57, 95% CI [-2.70, 1.56], P = .60), prolonged total sleep time (MD = 2.63, 95% CI [-0.59, 5.86], P = .11), and not increase adverse events (relative risk = 0.50, 95% CI [0.18, 1.44], P = .20). CONCLUSION EA may be a promising treatment for secondary sleep disorders; however, more high-quality studies are needed to confirm our findings.
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Affiliation(s)
- Shiping Liu
- School of Basic Medicine, Heilongjiang University of Traditional Chinese Medicine: Heilongjiang University of Chinese Medicine, Harbin, China
| | - Jie Liu
- School of Basic Medicine, Heilongjiang University of Traditional Chinese Medicine: Heilongjiang University of Chinese Medicine, Harbin, China
| | - Jinfeng Su
- School of Basic Medicine, Heilongjiang University of Traditional Chinese Medicine: Heilongjiang University of Chinese Medicine, Harbin, China
| | - Fuli Zhang
- School of Basic Medicine, Heilongjiang University of Traditional Chinese Medicine: Heilongjiang University of Chinese Medicine, Harbin, China
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Pinucci I, Maraone A, Tarsitani L, Pasquini M. Insomnia among Cancer Patients in the Real World: Optimising Treatments and Tailored Therapies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3785. [PMID: 36900794 PMCID: PMC10001409 DOI: 10.3390/ijerph20053785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 02/11/2023] [Accepted: 02/17/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Insomnia is commonly reported by cancer patients. Its multifaceted pathophysiology makes this symptom a complex challenge for the clinician, who should bear in mind the manifold world of causes and consequences of sleep disturbances in these patients and the importance of accurate treatment that should consider the frequent co-prescription of multiple medications. With our work, we aim to provide a tool to better master the treatment of this symptom in cancer patients, considering the gap between clinical and pharmacodynamic knowledge about the efficacy of different molecules and evidence-based prescribing. METHODS A narrative review of the studies investigating the pharmacological treatment of insomnia in cancer patients was conducted. Three hundred and seventy-six randomised controlled trials (RCTs), systematic reviews and meta-analyses were identified through PubMed. Only publications that investigated the efficacy of the pharmacological treatment of insomnia symptoms in cancer patient were considered. RESULTS Among the 376 publications that were individuated, fifteen studies were eligible for inclusion in the review and were described. Pharmacological treatments were outlined, with a broad look at specific clinical situations. CONCLUSIONS The management of insomnia in cancer patients should be personalised, as is already the case for the treatment of pain, taking into account both the pathophysiology and the other medical treatments prescribed to these patients.
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Lee YY, Endale M, Wu G, Ruben MD, Francey LJ, Morris AR, Choo NY, Anafi RC, Smith DF, Liu AC, Hogenesch JB. Integration of genome-scale data identifies candidate sleep regulators. Sleep 2023; 46:zsac279. [PMID: 36462188 PMCID: PMC9905783 DOI: 10.1093/sleep/zsac279] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 09/02/2022] [Indexed: 12/05/2022] Open
Abstract
STUDY OBJECTIVES Genetics impacts sleep, yet, the molecular mechanisms underlying sleep regulation remain elusive. In this study, we built machine learning models to predict sleep genes based on their similarity to genes that are known to regulate sleep. METHODS We trained a prediction model on thousands of published datasets, representing circadian, immune, sleep deprivation, and many other processes, using a manually curated list of 109 sleep genes. RESULTS Our predictions fit with prior knowledge of sleep regulation and identified key genes and pathways to pursue in follow-up studies. As an example, we focused on the NF-κB pathway and showed that chronic activation of NF-κB in a genetic mouse model impacted the sleep-wake patterns. CONCLUSION Our study highlights the power of machine learning in integrating prior knowledge and genome-wide data to study genetic regulation of complex behaviors such as sleep.
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Affiliation(s)
- Yin Yeng Lee
- Divisions of Human Genetics and Immunobiology, Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, 45229, USA
- Department of Pharmacology and Systems Physiology, University of Cincinnati College of Medicine, Cincinnati, OH 45229, USA
| | - Mehari Endale
- Department of Physiology and Aging, University of Florida College of Medicine, Gainesville, FL 32610, USA
| | - Gang Wu
- Divisions of Human Genetics and Immunobiology, Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, 45229, USA
| | - Marc D Ruben
- Divisions of Human Genetics and Immunobiology, Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, 45229, USA
| | - Lauren J Francey
- Divisions of Human Genetics and Immunobiology, Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, 45229, USA
| | - Andrew R Morris
- Department of Physiology and Aging, University of Florida College of Medicine, Gainesville, FL 32610, USA
| | - Natalie Y Choo
- Division of Pediatric Otolaryngology-Head and Neck Surgery, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA
| | - Ron C Anafi
- Department of Medicine, Chronobiology and Sleep Institute, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - David F Smith
- Division of Pediatric Otolaryngology-Head and Neck Surgery, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA
- Division of Pulmonary Medicine and the Sleep Center, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA
- Center for Circadian Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA
- Department of Otolaryngology - Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, OH 45229, USA
| | - Andrew C Liu
- Department of Physiology and Aging, University of Florida College of Medicine, Gainesville, FL 32610, USA
| | - John B Hogenesch
- Divisions of Human Genetics and Immunobiology, Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, 45229, USA
- Center for Circadian Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA
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Wolf S, Zanker J, Sommer F, Vlasenko D, Pinto DRM, Hoffmann M, Anthuber M, Schrempf MC. Immersive virtual reality fitness games for enhancement of recovery after colorectal surgery: study protocol for a randomised pilot trial. Pilot Feasibility Stud 2022; 8:256. [PMID: 36514093 PMCID: PMC9745969 DOI: 10.1186/s40814-022-01213-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 11/25/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Physical inactivity after surgery is an important risk factor for postoperative complications. Compared to conventional physiotherapy, activity-promoting video games are often more motivating and engaging for patients with physical impairments. This effect could be enhanced by immersive virtual reality (VR) applications that visually, aurally and haptically simulate a virtual environment and provide a more interactive experience. The use of VR-based fitness games in the early postoperative phase could contribute to improved mobilisation and have beneficial psychological effects. Currently, there is no data on the use of VR-based fitness games in the early postoperative period after colorectal surgery. METHODS This pilot trial features a single-centre, randomised, two-arm study design with a 1:1 allocation. Patients undergoing elective abdominal surgery for colorectal cancer or liver metastases of colorectal cancer will be recruited. Participants will be randomly assigned to an intervention group or a control group. Patients randomised to the intervention group will perform immersive virtual reality-based fitness exercises during their postoperative hospital stay. Feasibility and clinical outcomes will be assessed. DISCUSSION Early mobilisation after surgery is crucial for reducing many postoperative complications. VR-based interventions are easy to use and often inexpensive, especially compared to interventions that require more medical staff and equipment. VR-based interventions could serve as an alternative or complement to regular physiotherapy and enhance mobilisation after surgery. The proposed pilot study will be the first step to evaluate the feasibility of VR-based interventions in the perioperative period, with the aim of improving the postoperative rehabilitation of cancer patients. TRIAL REGISTRATION The trial has been registered in the German Clinical Trials Register (DRKS) Nr. DRKS00024888 , on April 13, 2021, WHO Universal Trial Number (UTN) U1111-1261-5968.
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Affiliation(s)
- Sebastian Wolf
- grid.419801.50000 0000 9312 0220Department of General, Visceral and Transplantation Surgery, University Hospital Augsburg, Stenglinstrasse 2, 86156 Augsburg, Germany
| | - Johannes Zanker
- grid.419801.50000 0000 9312 0220Department of General, Visceral and Transplantation Surgery, University Hospital Augsburg, Stenglinstrasse 2, 86156 Augsburg, Germany
| | - Florian Sommer
- grid.419801.50000 0000 9312 0220Department of General, Visceral and Transplantation Surgery, University Hospital Augsburg, Stenglinstrasse 2, 86156 Augsburg, Germany
| | - Dmytro Vlasenko
- grid.419801.50000 0000 9312 0220Department of General, Visceral and Transplantation Surgery, University Hospital Augsburg, Stenglinstrasse 2, 86156 Augsburg, Germany
| | - David R. M. Pinto
- grid.419801.50000 0000 9312 0220Department of General, Visceral and Transplantation Surgery, University Hospital Augsburg, Stenglinstrasse 2, 86156 Augsburg, Germany
| | - Michael Hoffmann
- grid.419801.50000 0000 9312 0220Department of General, Visceral and Transplantation Surgery, University Hospital Augsburg, Stenglinstrasse 2, 86156 Augsburg, Germany
| | - Matthias Anthuber
- grid.419801.50000 0000 9312 0220Department of General, Visceral and Transplantation Surgery, University Hospital Augsburg, Stenglinstrasse 2, 86156 Augsburg, Germany
| | - Matthias C. Schrempf
- grid.419801.50000 0000 9312 0220Department of General, Visceral and Transplantation Surgery, University Hospital Augsburg, Stenglinstrasse 2, 86156 Augsburg, Germany
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Integrative Approaches to the Treatment of Cancer. Cancers (Basel) 2022; 14:cancers14235933. [PMID: 36497414 PMCID: PMC9740147 DOI: 10.3390/cancers14235933] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 11/21/2022] [Accepted: 11/22/2022] [Indexed: 12/05/2022] Open
Abstract
A significant proportion of cancer patients use forms of complementary medicine or therapies. An integrative approach to cancer management combines conventional medicine with evidence-based complementary medicines/therapies and lifestyle interventions, for the treatment and prevention of disease and the optimisation of health. Its basis is a holistic one; to treat the whole person, not just the disease. It makes use of adjunct technologies which may assist the clinician in diagnosis of early carcinogenesis and monitoring of treatment effectiveness. Many factors contribute to the development of cancer including some which are largely modifiable by the patient and which oncologists may be in a position to advise on, such as stress, poor nutrition, lack of physical activity, poor sleep, and Vitamin D deficiency. An integrative approach to addressing these factors may contribute to better overall health of the patient and better outcomes. Evidence-based complementary medicine approaches include the use of supplements, herbal medicine, various practices that reduce stress, and physical therapies. Individualised to the patient, these can also help address the symptoms and signs associated with cancer and its orthodox treatment.
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Oliva D, Andersson BÅ, Lewin F, Jensen LD. Opposing inflammatory biomarker responses to sleep disruption in cancer patients before and during oncological therapy. Front Neurosci 2022; 16:945784. [PMID: 36213755 PMCID: PMC9534604 DOI: 10.3389/fnins.2022.945784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 08/25/2022] [Indexed: 01/08/2023] Open
Abstract
BackgroundSleep disruption is known to be highly prevalent in cancer patients, aggravated during oncological treatment and closely associated with reduced quality of life, therapeutic outcome and survival. Inflammatory factors are associated with sleep disruption in healthy individuals and cancer patients, but heterogeneity and robustness of inflammatory factors associated with sleep disruption and how these are affected by oncological therapy remain poorly understood. Furthermore, due to the complex crosstalk between sleep-, and therapy-associated factors, including inflammatory factors, there are currently no established biomarkers for predicting sleep disruption in patients undergoing oncological therapy.MethodsWe performed a broad screen of circulating biomarkers with immune-modulating or endocrine functions and coupled these to self-reported sleep quality using the Medical Outcomes Study (MOS) sleep scale. Ninety cancer patients with gastrointestinal, urothelial, breast, brain and tonsillar cancers, aged between 32 and 86 years, and scheduled for adjuvant or palliative oncological therapy were included. Of these, 71 patients were evaluable. Data was collected immediately before and again 3 months after onset of oncological therapy.ResultsSeventeen among a total of 45 investigated plasma proteins were found to be suppressed in cancer patients exhibiting sleep disruption prior to treatment onset, but this association was lost following the first treatment cycle. Patients whose sleep quality was reduced during the treatment period exhibited significantly increased plasma levels of six pro-inflammatory biomarkers (IL-2, IL-6, IL-12, TNF-a, IFN-g, and GM-CSF) 3 months after the start of treatment, whereas biomarkers with anti-inflammatory, growth factor, immune-modulatory, or chemokine functions were unchanged.ConclusionOur work suggests that biomarkers of sleep quality are not valid for cancer patients undergoing oncological therapy if analyzed only at a single timepoint. On the other hand, therapy-associated increases in circulating inflammatory biomarkers are closely coupled to reduced sleep quality in cancer patients. These findings indicate a need for testing of inflammatory and other biomarkers as well as sleep quality at multiple times during the patient treatment and care process.
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Affiliation(s)
- Delmy Oliva
- Department of Oncology, Ryhov County Hospital, Jönköping, Sweden
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
- *Correspondence: Delmy Oliva,
| | - Bengt-Åke Andersson
- Department of Natural Science and Biomedicine, School of Welfare, Jönköping University, Jönköping, Sweden
| | - Freddi Lewin
- Department of Oncology, Ryhov County Hospital, Jönköping, Sweden
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Lasse D. Jensen
- Division of Diagnostics and Specialist Medicine, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
- Lasse D. Jensen,
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Zhang J, Zhang Z, Huang S, Qiu X, Lao L, Huang Y, Zhang ZJ. Acupuncture for cancer-related insomnia: A systematic review and meta-analysis. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2022; 102:154160. [PMID: 35636168 DOI: 10.1016/j.phymed.2022.154160] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 04/08/2022] [Accepted: 05/05/2022] [Indexed: 05/12/2023]
Abstract
BACKGROUND Cancer-related insomnia is a highly prevalent complaint in cancer patients. However, there is no meta-analytic synthesis explored the efficacy of acupuncture for cancer-related insomnia among cancer patients undergoing active cancer treatments. OBJECTIVE This systematic review and meta-analysis were performed to explore the efficacy and safety of acupuncture for insomnia in people diagnosed with cancer. STUDY DESIGN Systematic review and meta-analysis of existing randomized controlled trials on acupuncture in the treatment of cancer-related insomnia. METHODS According to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) Statement, we identified and extracted the trials through November 2021 from ten databases and two trials record platforms (Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, PUBMED, Web of Science, PsycINFO, Allied and Complementary Medicine, Cumulative Index to Nursing and Allied Health Literature, China National Knowledge Infrastructure, Wanfang Digital Journals, ClinicalTrials, World Health Organization International Clinical Trials Registry Platform). The quality of the trials was assessed using Jadad score and Risk of Bias (2.0). A meta-analysis was synthesized using the random-effects model if the included studies were in high methodological quality. RESULTS A total of 690 studies were identified, with 22 were included in the review, and 6 of them were included in the quantitative synthesis. Studies were highly heterogeneous in terms of participant characteristics and study methodologies. Most studies recruited patients diagnosed with a specific cancer type, and breast cancer patients were the subgroup most represented. The qualitative review of available evidence suggested a beneficial efficacy of acupuncture on sleep without serious adverse events in several studies (55%). The meta-analysis revealed that acupuncture produced a significant improvement in the total Pittsburgh Sleep Quality Index (PSQI) score relative to the wait-list control among breast cancer patients undergoing active cancer treatments (MD -1.92, 95% CI -3.25 to -0.59, p = 0.005). Similar improvement of real and sham acupuncture on PSQI score change post-intervention was found (MD: -0.68, 95% CI: -2.44 to 1.07, p = 0.44). Manual acupuncture had similar effective rate as compared to estazolam immediately post-intervention (RR: 0.94, 95% CI: 0.87 to 1.01, p = 0.09), and had significantly better effective rate than estazolam at 1-week post-intervention follow-up (RR: 1.25, 95% CI: 1.10 to 1.43, p = 0.0009). All reported acupuncture related adverse events were mild or moderate in severity. CONCLUSION Acupuncture has great potential to be used to manage cancer-related insomnia for cancer patients or survivors. More studies with rigorous designs and larger sample size are warranted to verify the efficacy and safety of acupuncture for insomnia among people diagnosed with cancer, in particular among those with clinically significant insomnia. REGISTRATION PROSPERO (ID: CRD42021285844).
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Affiliation(s)
- Jialing Zhang
- School of Chinese Medicine, LKS Faculty of Medicine, the University of Hong Kong, Hong Kong, China.
| | - Zhinan Zhang
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong 510515, China.
| | - Shengtao Huang
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong 510515, China
| | - Xiaoke Qiu
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong 510515, China
| | - Lixing Lao
- Virginia University of Integrative Medicine, Fairfax, Virginia, United States of America
| | - Yong Huang
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong 510515, China.
| | - Zhang-Jin Zhang
- School of Chinese Medicine, LKS Faculty of Medicine, the University of Hong Kong, Hong Kong, China; Department of Chinese Medicine, the University of Hong Kong Shenzhen Hospital (HKU-SZH), Shenzhen, Guangdong 518053, China.
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Auricular Acupressure for Improving Sleep Quality in Patients With Lung Cancer: A Systematic Review and Meta-analysis. Holist Nurs Pract 2022; 36:E27-E37. [PMID: 35708563 DOI: 10.1097/hnp.0000000000000532] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This meta-analysis was conducted to systematically evaluate the efficacy and safety of auricular acupressure on sleep quality in patients with lung cancer. Nine articles with a total of 802 patients were retrieved after searching on 11 electronic databases. Results of the meta-analysis showed that auricular acupressure improved sleep score (standard mean difference: -0.80, 95% confidence intervals: -1.30 to -0.30, P = .002) and reduced sleep disturbance rate (risk ratio: 0.65, 95% confidence intervals: 0.51-0.84, P = .001) and sleep medicine usage (risk ratio: 0.26, 95% confidence intervals: 0.11-0.65, P = .004) significantly. Our review suggests that auricular acupressure is effective and relatively safe in improving sleep quality among patients with lung cancer.
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Wilunda C, Abe SK, Svensson T, Sawada N, Tsugane S, Wada K, Nagata C, Kimura T, Tamakoshi A, Sugawara Y, Tsuji I, Ito H, Kitamura T, Sakata R, Mizoue T, Matsuo K, Tanaka K, Lin Y, Inoue M. Sleep duration and risk of cancer incidence and mortality: a pooled analysis of six population-based cohorts in Japan. Int J Cancer 2022; 151:1068-1080. [PMID: 35616624 DOI: 10.1002/ijc.34133] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 04/23/2022] [Accepted: 04/26/2022] [Indexed: 11/09/2022]
Abstract
Sleep duration is emerging as an important modifiable risk factor for morbidity and mortality. We assessed the association between sleep duration and cancer incidence and mortality among Japanese adults using data from six population-based cohorts with 271 694 participants. During a total follow-up period of about 5.9 million person-years, we identified 40 751 incident cancer cases and 18 323 cancer deaths. We computed study-specific hazard ratios (HRs) and 95% confidence intervals (CIs) using Cox proportional hazards regression models and pooled the estimates using random-effects meta-analysis. Sleep duration of ≥ 10 h (vs. 7 h) was associated with increased risk of cancer incidence among women (HR 1.19, 95% CI 1.02-1.38), but not men, and increased risk of cancer mortality among men (HR 1.18, 95% CI 1.00-1.39) and women (HR 1.44, 95% CI 1.20-1.73). Sleep duration of ≤ 5 h (vs. 7 h) was not associated with cancer incidence and mortality. However, among post-menopausal women, sleep durations of both ≤ 5 h and ≥ 10 h (vs. 7 h) were associated with an increased risk of cancer mortality. Among Japanese adults, sleep duration of ≥ 10 h is associated with increased risk of cancer incidence and mortality among women and cancer mortality among men. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Calistus Wilunda
- Division of Cohort Research, National Cancer Center Institute for Cancer Control, Tokyo, Japan.,Health and Wellness Unit, African Population and Health Research Center, Nairobi, Kenya
| | - Sarah Krull Abe
- Division of Prevention, National Cancer Center Institute for Cancer Control, Tokyo, Japan
| | - Thomas Svensson
- Division of Prevention, National Cancer Center Institute for Cancer Control, Tokyo, Japan.,School of Health Innovation, Kanagawa University of Human Services, Kanagawa, Japan.,Precision Health, Department of Bioengineering, Graduate School of Engineering, The University of Tokyo, Tokyo, Japan.,Department of Clinical Sciences, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Norie Sawada
- Division of Cohort Research, National Cancer Center Institute for Cancer Control, Tokyo, Japan
| | - Shoichiro Tsugane
- Division of Cohort Research, National Cancer Center Institute for Cancer Control, Tokyo, Japan.,National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan
| | - Keiko Wada
- Department of Epidemiology and Preventive Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Chisato Nagata
- Department of Epidemiology and Preventive Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Takashi Kimura
- Department of Public Health, Hokkaido University Faculty of Medicine, Sapporo, Japan
| | - Akiko Tamakoshi
- Department of Public Health, Hokkaido University Faculty of Medicine, Sapporo, Japan
| | - Yumi Sugawara
- Division of Epidemiology, Department of Public Health and Forensic Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Ichiro Tsuji
- Division of Epidemiology, Department of Public Health and Forensic Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hidemi Ito
- Division of Cancer Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Japan
| | - Tetsuhisa Kitamura
- Department of Social Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Ritsu Sakata
- Department of Epidemiology, Radiation Effects Research Foundation, Hiroshima, Japan
| | - Tetsuya Mizoue
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Keitaro Matsuo
- Division of Cancer Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Japan
| | - Keitaro Tanaka
- Department of Preventive Medicine, Faculty of Medicine, Saga University, Saga, Japan
| | - Yingsong Lin
- Department of Public Health, School of Medicine, Aichi Medical University, Nagakute, Japan
| | - Manami Inoue
- Division of Cohort Research, National Cancer Center Institute for Cancer Control, Tokyo, Japan.,Division of Prevention, National Cancer Center Institute for Cancer Control, Tokyo, Japan
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13
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Kaur P, Mohamed NE, Archer M, Figueiro MG, Kyprianou N. Impact of Circadian Rhythms on the Development and Clinical Management of Genitourinary Cancers. Front Oncol 2022; 12:759153. [PMID: 35356228 PMCID: PMC8959649 DOI: 10.3389/fonc.2022.759153] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 01/24/2022] [Indexed: 01/27/2023] Open
Abstract
The circadian system is an innate clock mechanism that governs biological processes on a near 24-hour cycle. Circadian rhythm disruption (i.e., misalignment of circadian rhythms), which results from the lack of synchrony between the master circadian clock located in the suprachiasmatic nuclei (SCN) and the environment (i.e., exposure to day light) or the master clock and the peripheral clocks, has been associated with increased risk of and unfavorable cancer outcomes. Growing evidence supports the link between circadian disruption and increased prevalence and mortality of genitourinary cancers (GU) including prostate, bladder, and renal cancer. The circadian system also plays an essential role on the timely implementation of chronopharmacological treatments, such as melatonin and chronotherapy, to reduce tumor progression, improve therapeutic response and reduce negative therapy side effects. The potential benefits of the manipulating circadian rhythms in the clinical setting of GU cancer detection and treatment remain to be exploited. In this review, we discuss the current evidence on the influence of circadian rhythms on (disease) cancer development and hope to elucidate the unmet clinical need of defining the extensive involvement of the circadian system in predicting risk for GU cancer development and alleviating the burden of implementing anti-cancer therapies.
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Affiliation(s)
- Priya Kaur
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Nihal E. Mohamed
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Maddison Archer
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Mariana G. Figueiro
- Light and Health Research Center, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, United States,Tisch Cancer Institute, Mount Sinai Health, New York, NY, United States,*Correspondence: Natasha Kyprianou, ; Mariana G. Figueiro,
| | - Natasha Kyprianou
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY, United States,Tisch Cancer Institute, Mount Sinai Health, New York, NY, United States,Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, United States,*Correspondence: Natasha Kyprianou, ; Mariana G. Figueiro,
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14
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O’Brien K. Cannabidiol (CBD) in Cancer Management. Cancers (Basel) 2022; 14:cancers14040885. [PMID: 35205633 PMCID: PMC8869992 DOI: 10.3390/cancers14040885] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 01/28/2022] [Accepted: 02/05/2022] [Indexed: 12/23/2022] Open
Abstract
Simple Summary Cannabidiol (CBD) is one of the main constituents of the plant Cannabis sativa. Surveys suggest that medicinal cannabis is popular amongst people diagnosed with cancer. CBD is one of the key constituents of cannabis, and does not have the potentially intoxicating effects that tetrahydrocannabinol (THC), the other key phytocannabinoid has. Research indicates the CBD may have potential for the treatment of cancer, including the symptoms and signs associated with cancer and its treatment. Preclinical research suggests CBD may address many of the pathways involved in the pathogenesis of cancers. Preclinical and clinical research also suggests some evidence of efficacy, alone or in some cases in conjunction with tetrahydrocannabinol (THC, the other key phytocannabinoid in cannabis), in treating cancer-associated pain, anxiety and depression, sleep problems, nausea and vomiting, and oral mucositis that are associated with cancer and/or its treatment. Studies also suggest that CBD may enhance orthodox treatments with chemotherapeutic agents and radiation therapy and protect against neural and organ damage. CBD shows promise as part of an integrative approach to the management of cancer. Abstract The plant Cannabis sativa has been in use medicinally for several thousand years. It has over 540 metabolites thought to be responsible for its therapeutic effects. Two of the key phytocannabinoids are cannabidiol (CBD) and tetrahydrocannabinol (THC). Unlike THC, CBD does not have potentially intoxicating effects. Preclinical and clinical research indicates that CBD has a wide range of therapeutic effects, and many of them are relevant to the management of cancer. In this article, we explore some of the potential mechanisms of action of CBD in cancer, and evidence of its efficacy in the integrative management of cancer including the side effects associated with its treatment, demonstrating its potential for integration with orthodox cancer care.
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Affiliation(s)
- Kylie O’Brien
- Adelaide Campus, Torrens University, Adelaide, SA 5000, Australia;
- NICM Health Research Centre, Western Sydney University, Westmead, Sydney, NSW 2145, Australia
- Releaf Group Ltd., St Kilda, VIC 3182, Australia
- International College of Cannabinoid Medicine, iccm.co, London N1 7GU, UK
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15
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Sleep moderates the effects of Tibetan yoga for women with breast cancer undergoing chemotherapy. Support Care Cancer 2022; 30:4477-4484. [PMID: 35107599 DOI: 10.1007/s00520-022-06861-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 01/21/2022] [Indexed: 10/19/2022]
Abstract
This study examined self-reported and actigraphy-assessed sleep and depression as moderators of the effect of a Tibetan yoga intervention on sleep and depression among women undergoing chemotherapy for breast cancer. This is a secondary analysis of an RCT examining a 4-session Tibetan yoga program (TYP; n = 74) versus stretching program (STP; n = 68) or usual care (UC; n = 85) on self-reported sleep (Pittsburgh Sleep Quality Index (PSQI), actigraphy-assessed sleep efficiency (SE)) and depression (Centers for Epidemiological Studies Depression Scale; CES-D) for women undergoing chemotherapy for breast cancer. Data were collected at baseline and 1-week and 3-month post-intervention. Baseline PSQI, actigraphy-SE, and CES-D were examined as moderators of the effect of group on PSQI, actigraphy-SE, and CES-D 1 week and 3 months after treatment. There was a significant baseline actigraphy-SE × group effect on PSQI at 1 week (p < .001) and 3 months (p = .002) and on CES-D at 3 months (p = .049). Specifically, the negative association of baseline actigraphy-SE with subsequent PSQI and CES-D was buffered for women in the TYP and, to a lesser extent in STP, compared to those in the UC. Baseline PSQI and CES-D were not significant moderators of the effect of group on any outcome. Behaviorally assessed sleep may be a more robust indicator of which patients are most appropriate for a yoga intervention than self-reported sleep quality. Women with poor sleep efficiency may derive the greatest benefit in terms of sleep quality and mood from a yoga intervention.
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16
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Shu Z, Wang J, Sun H, Xu N, Lu C, Zhang R, Li X, Liu B, Zhou X. Diversity and molecular network patterns of symptom phenotypes. NPJ Syst Biol Appl 2021; 7:41. [PMID: 34848731 PMCID: PMC8632989 DOI: 10.1038/s41540-021-00206-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 11/01/2021] [Indexed: 11/08/2022] Open
Abstract
Symptom phenotypes have continuously been an important clinical entity for clinical diagnosis and management. However, non-specificity of symptom phenotypes for clinical diagnosis is one of the major challenges that need be addressed to advance symptom science and precision health. Network medicine has delivered a successful approach for understanding the underlying mechanisms of complex disease phenotypes, which will also be a useful tool for symptom science. Here, we extracted symptom co-occurrences from clinical textbooks to construct phenotype network of symptoms with clinical co-occurrence and incorporated high-quality symptom-gene associations and protein-protein interactions to explore the molecular network patterns of symptom phenotypes. Furthermore, we adopted established network diversity measure in network medicine to quantify both the phenotypic diversity (i.e., non-specificity) and molecular diversity of symptom phenotypes. The results showed that the clinical diversity of symptom phenotypes could partially be explained by their underlying molecular network diversity (PCC = 0.49, P-value = 2.14E-08). For example, non-specific symptoms, such as chill, vomiting, and amnesia, have both high phenotypic and molecular network diversities. Moreover, we further validated and confirmed the approach of symptom clusters to reduce the non-specificity of symptom phenotypes. Network diversity proposes a useful approach to evaluate the non-specificity of symptom phenotypes and would help elucidate the underlying molecular network mechanisms of symptom phenotypes and thus promotes the advance of symptom science for precision health.
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Affiliation(s)
- Zixin Shu
- Institute of Medical Intelligence, School of Computer and Information Technology, Beijing Jiaotong University, Beijing, 100063, China
| | - Jingjing Wang
- Institute of Medical Intelligence, School of Computer and Information Technology, Beijing Jiaotong University, Beijing, 100063, China
| | - Hailong Sun
- Institute of Medical Intelligence, School of Computer and Information Technology, Beijing Jiaotong University, Beijing, 100063, China
| | - Ning Xu
- The First Affiliated Hospital of Henan University of Chinese Medicine (Co-construction Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases by Henan, Henan University of Chinese Medicine), Zhengzhou, 450046, China
| | - Chenxia Lu
- Hubei Provincial Hospital of Traditional Chinese Medicine (Affiliated Hospital of Hubei University of Traditional Chinese Medicine, Hubei Academy of Traditional Chinese Medicine), Wuhan, 430061, China
| | - Runshun Zhang
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, China
| | - Xiaodong Li
- Hubei Provincial Hospital of Traditional Chinese Medicine (Affiliated Hospital of Hubei University of Traditional Chinese Medicine, Hubei Academy of Traditional Chinese Medicine), Wuhan, 430061, China
| | - Baoyan Liu
- China Academy of Chinese Medical Sciences, Beijing, 100700, China
| | - Xuezhong Zhou
- Institute of Medical Intelligence, School of Computer and Information Technology, Beijing Jiaotong University, Beijing, 100063, China.
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17
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Hidde MC, Leach HJ, Marker RJ, Peters JC, Purcell WT. Effects of a Clinic-Based Exercise Program on Sleep Disturbance Among Cancer Survivors. Integr Cancer Ther 2021; 19:1534735420975852. [PMID: 33243013 PMCID: PMC7705805 DOI: 10.1177/1534735420975852] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Introduction Sleep disturbance is the second leading negative side effect reported by cancer survivors, and evidence exists to suggest that exercise may improve sleep for cancer survivors. This study examined changes in sleep following a 3-month, clinic-based exercise program among a diverse group of cancer survivors. Methods Single group, pre-post study design. Participants were enrolled in a supervised exercise program which consisted of moderate intensity aerobic and resistance training, twice per week for 3-months. To be eligible, individuals had to be diagnosed with cancer, and undergoing, or within 6-months of completing chemo and/or radiation therapy. Sleep was assessed at pre-and post-program using 3 self-report questions as part of a standard wellness assessment conducted at the program’s facility. Changes in categorical outcomes were evaluated using McNemar and Wilcoxon Signed-Rank Tests. Results Participants (N = 94) were mostly female (68.1%, N = 64), mean age = 54.26 ± 14.26 (20-78), and diagnosed with more than 8 different cancer types. Half (N = 48, 51.1%) of participants improved on 1 or more of the questions assessing sleep. At post-program, 39% of participants reported that they did not awaken feeling rested versus 48% at pre-program (P = .08). At post-program, 47% reported awakening ≥1 time per night versus 46% at pre-program (P = .97), and 17% reported poor or very poor sleep quality at post-program versus 24% at pre-program (P = .16). There were no differences in demographic, cancer-related, psychosocial, and physical fitness variables between participants who improved on any of the questions assessing sleep versus those who did not. Conclusions A clinically implemented exercise program may help some cancer survivors improve sleep, however more studies utilizing validated, objective measures of sleep are needed to confirm effectiveness.
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Affiliation(s)
- Mary C Hidde
- Department of Health and Exercise Science, Colorado State University, Fort Collins, CO, USA
| | - Heather J Leach
- Department of Health and Exercise Science, Colorado State University, Fort Collins, CO, USA.,Department of Community and Behavioral Health, Colorado School of Public Health at Colorado State University, Fort Collins, CO, USA
| | - Ryan J Marker
- Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - John C Peters
- Anchutz Health and Wellness Center, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - W Thomas Purcell
- School of Medicine, University of Colorado, Aurora, CO, USA.,University of Colorado Cancer Center, Aurora, CO, USA
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18
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Mampay M, Flint MS, Sheridan GK. Tumour brain: Pretreatment cognitive and affective disorders caused by peripheral cancers. Br J Pharmacol 2021; 178:3977-3996. [PMID: 34029379 DOI: 10.1111/bph.15571] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 04/12/2021] [Accepted: 05/05/2021] [Indexed: 12/20/2022] Open
Abstract
People that develop extracranial cancers often display co-morbid neurological disorders, such as anxiety, depression and cognitive impairment, even before commencement of chemotherapy. This suggests bidirectional crosstalk between non-CNS tumours and the brain, which can regulate peripheral tumour growth. However, the reciprocal neurological effects of tumour progression on brain homeostasis are not well understood. Here, we review brain regions involved in regulating peripheral tumour development and how they, in turn, are adversely affected by advancing tumour burden. Tumour-induced activation of the immune system, blood-brain barrier breakdown and chronic neuroinflammation can lead to circadian rhythm dysfunction, sleep disturbances, aberrant glucocorticoid production, decreased hippocampal neurogenesis and dysregulation of neural network activity, resulting in depression and memory impairments. Given that cancer-related cognitive impairment diminishes patient quality of life, reduces adherence to chemotherapy and worsens cancer prognosis, it is essential that more research is focused at understanding how peripheral tumours affect brain homeostasis.
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Affiliation(s)
- Myrthe Mampay
- School of Pharmacy and Biomolecular Sciences, University of Brighton, Brighton, UK
| | - Melanie S Flint
- School of Pharmacy and Biomolecular Sciences, University of Brighton, Brighton, UK
| | - Graham K Sheridan
- School of Life Sciences, Queen's Medical Centre, University of Nottingham, Nottingham, UK
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19
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Mc Carthy CE. Sleep Disturbance, Sleep Disorders and Co-Morbidities in the Care of the Older Person. Med Sci (Basel) 2021; 9:medsci9020031. [PMID: 34063838 PMCID: PMC8162526 DOI: 10.3390/medsci9020031] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 05/17/2021] [Accepted: 05/18/2021] [Indexed: 01/14/2023] Open
Abstract
Sleep complaints can be both common and complex in the older patient. Their consideration is an important aspect of holistic care, and may have an impact on quality of life, mortality, falls and disease risk. Sleep assessment should form part of the comprehensive geriatric assessment. If sleep disturbance is brought to light, consideration of sleep disorders, co-morbidity and medication management should form part of a multifaceted approach. Appreciation of the bi-directional relationship and complex interplay between co-morbidity and sleep in older patients is an important element of patient care. This article provides a brief overview of sleep disturbance and sleep disorders in older patients, in addition to their association with specific co-morbidities including depression, heart failure, respiratory disorders, gastro-oesophageal reflux disease, nocturia, pain, Parkinson's disease, dementia, polypharmacy and falls. A potential systematic multidomain approach to assessment and management is outlined, with an emphasis on non-pharmacological treatment where possible.
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Affiliation(s)
- Christine E. Mc Carthy
- Department of Geriatric Medicine, University Hospital Galway, Galway, Ireland;
- HRB-Clinical Research Facility, National University of Ireland, Galway, Co., Galway, Ireland
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20
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Prevalence of Insomnia among Pancreatic Cancer Patients following Pancreaticoduodenectomy. SLEEP DISORDERS 2021; 2021:5535220. [PMID: 34055415 PMCID: PMC8112949 DOI: 10.1155/2021/5535220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 04/11/2021] [Accepted: 04/13/2021] [Indexed: 12/24/2022]
Abstract
Introduction Sleep disturbances are more common in cancer patients than in the general population; however, there is limited research pertaining to the occurrence of such disturbances that subsequently impact patients' quality of life. The aim of our study is to describe the prevalence of insomnia among pancreatic cancer patients who have recently undergone recent pancreaticoduodenectomy. Methods We performed a 6-year (2014-2020) retrospective cohort analysis of all adult patients aged 18 and above with pancreatic cancer who underwent pancreaticoduodenectomy at our institution. Insomnia was characterized using the Pittsburgh Sleep Quality Index (PSQI). Symptoms of insomnia and the impact caused by these symptoms on daily lives were assessed with the Insomnia Severity Index (ISI), and patients were divided into mild insomnia (ISI 8–14) or moderate to severe insomnia (ISI ≥ 15). Results Out of forty patients with pancreatic cancer that have undergone pancreaticoduodenectomy, 19 (47.2%) reported that their sleep disturbances had a significant effect on their quality of life. A total of 22 (55.0%) patients reported insomnia, with 63.2% reporting mild insomnia. Chemotherapy was found to significantly increase the risk of moderate to severe insomnia. The mean ISI score was 7.2 ± 6.9, and the mean PSQI score was 7.0 ± 5.1. ISI and PSQI showed a strong positive correlation (r = 0.78, p < 0.01). Conclusion Sleep disturbances such as insomnia following pancreatic cancer surgery are highly prevalent. Treating physicians and surgeons should recognize and routinely screen for sleep disorders through the management of a multidisciplinary team in order to alleviate some of the burden on the patients' mental well-being.
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21
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Schrempf MC, Petzold JQ, Vachon H, Petersen MA, Gutschon J, Wolf S, Sommer F, Murnauer M, Anthuber M. Virtual reality-based relaxation for enhancement of perioperative well-being and quality of life: protocol for a randomised pilot trial. BMJ Open 2021; 11:e044193. [PMID: 33827835 PMCID: PMC8031039 DOI: 10.1136/bmjopen-2020-044193] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION Patients with cancer undergoing surgery often suffer from reduced quality of life and various forms of distress. Untreated distress can negatively affect coping resources as well as surgical and oncological outcomes. A virtual reality-based stress reduction intervention may increase quality of life and well-being and reduce distress in the perioperative phase for patients with cancer. This pilot trial aims to explore the feasibility of the proposed intervention, assess patient acceptability and obtain estimates of effect to provide data for sample size calculations. METHODS AND ANALYSIS Patients with colorectal cancer and liver metastasis undergoing elective surgery will be recruited for this single-centre, randomised pilot trial with a three-arm design. A total of 54 participants will be randomised at 1:1:1 ratio to one of two intervention groups or a control receiving standard treatment. Those randomised to an intervention group will either receive perioperative virtual reality-based stress reduction exercises twice daily or listen to classical music twice daily. Primary feasibility outcomes are number and proportions of participants recruited, screened, consented and randomised. Furthermore, adherence to the intervention, compliance with the completion of the quality of life questionnaires and feasibility of implementing the trial procedures will be assessed. Secondary clinical outcomes are measurements of the effectiveness of the interventions to inform sample size calculations. ETHICS AND DISSEMINATION The study protocol, the patient information and the informed consent form have been approved by the ethics committee of the Ludwigs-Maximilians-University, Munich, Germany (Reference Number: 19-915). Study findings will be submitted for publication in peer-reviewed journals. TRIAL REGISTRATION NUMBER DRKS00020909.
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Affiliation(s)
- Matthias Christian Schrempf
- Department of General, Visceral and Transplantation Surgery, University Hospital of Augsburg, Augsburg, Germany
| | - Julian Quirin Petzold
- Department of General, Visceral and Transplantation Surgery, University Hospital of Augsburg, Augsburg, Germany
| | - Hugo Vachon
- Quality of Life Department, European Organisation for Research and Treatment of Cancer, Brussels, Belgium
| | - Morten Aagaard Petersen
- The Research Unit, Department of Palliative Medicine, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Kobenhavn, Denmark
| | - Johanna Gutschon
- Department of General, Visceral and Transplantation Surgery, University Hospital of Augsburg, Augsburg, Germany
| | - Sebastian Wolf
- Department of General, Visceral and Transplantation Surgery, University Hospital of Augsburg, Augsburg, Germany
| | - Florian Sommer
- Department of General, Visceral and Transplantation Surgery, University Hospital of Augsburg, Augsburg, Germany
| | - Marcus Murnauer
- Department of General, Visceral and Transplantation Surgery, University Hospital of Augsburg, Augsburg, Germany
| | - Matthias Anthuber
- Department of General, Visceral and Transplantation Surgery, University Hospital of Augsburg, Augsburg, Germany
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22
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Peoples AR, Pigeon WR, Li D, Garland SN, Perlis ML, Inglis JE, Vinciguerra V, Anderson T, Evans LS, Wade JL, Ossip DJ, Morrow GR, Wolf JR. Association Between Pretreatment Sleep Disturbance and Radiation Therapy-Induced Pain in 573 Women With Breast Cancer. J Pain Symptom Manage 2021; 61:254-261. [PMID: 32768555 PMCID: PMC7854971 DOI: 10.1016/j.jpainsymman.2020.07.041] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 07/28/2020] [Accepted: 07/31/2020] [Indexed: 02/08/2023]
Abstract
CONTEXT Pain can be a debilitating side effect of radiation therapy (RT). Data from the general population have shown that sleep disturbance can influence pain incidence and severity; however, less is known about this relationship in patients with breast cancer receiving RT. OBJECTIVES This secondary analysis examined the association of pretreatment moderate/severe levels of sleep disturbance with subsequent RT-induced pain after adjusting for pre-RT pain. METHODS We report on 573 female patients with breast cancer undergoing RT from a previously completed Phase II clinical trial for radiation dermatitis. Sleep disturbance, total pain, and pain subdomains-sensory pain, affective pain, and perceived pain intensity were assessed at pre-RT and post-RT. At pre-RT, patients were dichotomized into two groups: those with moderate/severe sleep disturbance (N = 85) vs. those with no/mild sleep disturbance (control; N = 488). RESULTS At pre-RT, women with moderate/severe sleep disturbance were younger, less likely to be married, more likely to have had mastectomy and chemotherapy, and more likely to have depression/anxiety disorder and fatigue than the control group (all Ps < 0.05). Generalized estimating equations model, after controlling for pre-RT pain and other covariates (e.g., trial treatment condition and covariates that were significantly correlated with post-RT pain), showed that women with moderate/severe sleep disturbance at pre-RT vs. control group had significantly higher mean post-RT total pain as well as sensory, affective, and perceived pain (effect size = 0.62, 0.60, 0.69, and 0.52, respectively; all Ps < 0.05). CONCLUSION These findings suggest that moderate/severe disturbed sleep before RT is associated with increased pain from pre-to-post-RT in patients with breast cancer.
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Affiliation(s)
- Anita R Peoples
- Clinical and Translational Science Institute, University of Rochester Medical Center, Rochester, New York, USA.
| | - Wilfred R Pigeon
- Department of Psychiatry, University of Rochester Medical Center, Rochester, New York, USA; Department of Public Health Sciences, University of Rochester Medical Center, Rochester, New York, USA
| | - Dongmei Li
- Clinical and Translational Science Institute, University of Rochester Medical Center, Rochester, New York, USA
| | - Sheila N Garland
- Departments of Psychology and Oncology, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada
| | - Michael L Perlis
- Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Julia E Inglis
- Department of Surgery, University of Rochester Medical Center, Rochester, New York, USA
| | | | | | - Lisa S Evans
- Southeast Clinical Oncology Research Consortium NCORP, Winston-Salem, North Carolina, USA
| | - James L Wade
- Heartland Cancer Research NCORP, Decatur, Illinois, USA
| | - Deborah J Ossip
- Clinical and Translational Science Institute, University of Rochester Medical Center, Rochester, New York, USA; Department of Public Health Sciences, University of Rochester Medical Center, Rochester, New York, USA
| | - Gary R Morrow
- Department of Surgery, University of Rochester Medical Center, Rochester, New York, USA
| | - Julie Ryan Wolf
- Departments of Dermatology and Radiation Oncology, University of Rochester Medical Center, Rochester, New York, USA
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23
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Chen M, Singh AK, Repasky EA. Highlighting the Potential for Chronic Stress to Minimize Therapeutic Responses to Radiotherapy through Increased Immunosuppression and Radiation Resistance. Cancers (Basel) 2020; 12:E3853. [PMID: 33419318 PMCID: PMC7767049 DOI: 10.3390/cancers12123853] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 12/15/2020] [Accepted: 12/16/2020] [Indexed: 02/07/2023] Open
Abstract
Ionizing radiation has been used in the treatment of cancer for more than 100 years. While often very effective, there is still a great effort in place to improve the efficacy of radiation therapy for controlling the progression and recurrence of tumors. Recent research has revealed the close interaction between nerves and tumor progression, especially nerves of the autonomic nervous system that are activated by a variety of stressful stimuli including anxiety, pain, sleep loss or depression, each of which is likely to be increased in cancer patients. A growing literature now points to a negative effect of chronic stressful stimuli in tumor progression. In this review article, we present data on the potential for adrenergic stress to influence the efficacy of radiation and in particular, its potential to influence the anti-tumor immune response, and the frequency of an "abscopal effect" or the shrinkage of tumors which are outside an irradiated field. We conclude that chronic stress can be a major impediment to more effective radiation therapy through mechanisms involving immunosuppression and increased resistance to radiation-induced tumor cell death. Overall, these data highlight the potential value of stress reduction strategies to improve the outcome of radiation therapy. At the same time, objective biomarkers that can accurately and objectively reflect the degree of stress in patients over prolonged periods of time, and whether it is influencing immunosuppression and radiation resistance, are also critically needed.
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Affiliation(s)
- Minhui Chen
- Department of Immunology, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA;
| | - Anurag K. Singh
- Department of Radiation Oncology, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA;
| | - Elizabeth A. Repasky
- Department of Immunology, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA;
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24
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Pandey A, Oliver R, Kar SK. Differential Gene Expression in Brain and Liver Tissue of Wistar Rats after Rapid Eye Movement Sleep Deprivation. Clocks Sleep 2020; 2:442-465. [PMID: 33114225 PMCID: PMC7711450 DOI: 10.3390/clockssleep2040033] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 10/13/2020] [Accepted: 10/21/2020] [Indexed: 02/06/2023] Open
Abstract
Sleep is essential for the survival of most living beings. Numerous researchers have identified a series of genes that are thought to regulate "sleep-state" or the "deprived state". As sleep has a significant effect on physiology, we believe that lack of total sleep, or particularly rapid eye movement (REM) sleep, for a prolonged period would have a profound impact on various body tissues. Therefore, using the microarray method, we sought to determine which genes and processes are affected in the brain and liver of rats following nine days of REM sleep deprivation. Our findings showed that REM sleep deprivation affected a total of 652 genes in the brain and 426 genes in the liver. Only 23 genes were affected commonly, 10 oppositely, and 13 similarly across brain and liver tissue. Our results suggest that nine-day REM sleep deprivation differentially affects genes and processes in the brain and liver of rats.
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Affiliation(s)
- Atul Pandey
- School of Biotechnology, Jawaharlal Nehru University, New Delhi 110067, India
- Department of Ecology, Evolution, and Behavior, The Alexander Silberman Institute of Life Sciences, The Hebrew University of Jerusalem, Jerusalem 91904, Israel;
| | - Ryan Oliver
- Department of Ecology, Evolution, and Behavior, The Alexander Silberman Institute of Life Sciences, The Hebrew University of Jerusalem, Jerusalem 91904, Israel;
| | - Santosh K Kar
- School of Biotechnology, Jawaharlal Nehru University, New Delhi 110067, India
- Nano Herb Research Laboratory, Kalinga Institute of Industrial Technology (KIIT) Technology Bio Incubator, Campus-11, KIIT Deemed to be University, Bhubaneswar, Odisha 751024, India
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25
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Porciello G, Montagnese C, Crispo A, Grimaldi M, Libra M, Vitale S, Palumbo E, Pica R, Calabrese I, Cubisino S, Falzone L, Poletto L, Martinuzzo V, Prete M, Esindi N, Thomas G, Cianniello D, Pinto M, Laurentiis MD, Pacilio C, Rinaldo M, D’Aiuto M, Serraino D, Massarut S, Evangelista C, Steffan A, Catalano F, Banna GL, Scandurra G, Ferraù F, Rossello R, Antonelli G, Guerra G, Farina A, Messina F, Riccardi G, Gatti D, Jenkins DJA, Minopoli A, Grilli B, Cavalcanti E, Celentano E, Botti G, Montella M, Augustin LSA. Mediterranean diet and quality of life in women treated for breast cancer: A baseline analysis of DEDiCa multicentre trial. PLoS One 2020; 15:e0239803. [PMID: 33031478 PMCID: PMC7544033 DOI: 10.1371/journal.pone.0239803] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Accepted: 09/15/2020] [Indexed: 02/08/2023] Open
Abstract
Evidence suggests a beneficial role of the Mediterranean Diet (MedDiet) on health-related quality of life (HRQoL) in healthy subjects. HRQoL is relevant in cancer therapy and disease outcomes, therefore we investigated the association between adherence to the MedDiet and HRQoL in breast cancer survivors participating in the multicentre trial DEDiCa. Diet and HRQoL were assessed at baseline in a subgroup of 309 women enrolled within 12 months of breast cancer diagnosis without metastasis (stages I-III, mean age 52±1 yrs, BMI 27±7 kg/m2). The 14-item PREDIMED questionnaire was used to analyse adherence to the MedDiet. HRQoL was assessed with three validated questionnaires measuring physical, mental, emotional and social factors: EQ-5D-3L, EORTC QLQ-C30 and EORTC QLQ-BR23. Analysis of variance (ANOVA) and multivariate analyses were performed to assess the possible role of the MedDiet on HRQoL. Patients with higher adherence to MedDiet (PREDIMED score >7) showed significantly higher scores for physical functioning (p = 0.02) and lower scores on the symptomatic pain scale (p = 0.04) assessed by the EORTC QLQ-C30 questionnaire compared to patients with a lower adherence to MedDiet (PREDIMED score ≤7). Higher scores from the EQ-5D-3L indicating higher well-being were observed mainly in participants with higher MedDiet adherence (p = 0.05). In adjusted multivariate analyses significant positive associations were found between MedDiet, physical functioning (p = 0.001) and EQ 5D-3L score (p = 0.003) while inverse associations were found with pain and insomnia symptoms (p = 0.005 and p = 0.029, respectively). These results suggest that higher adherence to the MedDiet in breast cancer survivors is associated with better aspects of quality of life, specifically higher physical functioning, better sleep, lower pain and generally higher well-being confirming findings in healthy subjects.
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Affiliation(s)
- Giuseppe Porciello
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori—IRCCS "Fondazione G. Pascale", Napoli, Italy
| | - Concetta Montagnese
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori—IRCCS "Fondazione G. Pascale", Napoli, Italy
- * E-mail:
| | - Anna Crispo
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori—IRCCS "Fondazione G. Pascale", Napoli, Italy
| | - Maria Grimaldi
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori—IRCCS "Fondazione G. Pascale", Napoli, Italy
| | - Massimo Libra
- Department of Biomedical and Biotechnological Sciences Oncologic, Clinical and General Pathology Section, University of Catania, Catania, Italy
| | - Sara Vitale
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori—IRCCS "Fondazione G. Pascale", Napoli, Italy
| | - Elvira Palumbo
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori—IRCCS "Fondazione G. Pascale", Napoli, Italy
| | - Rosa Pica
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori—IRCCS "Fondazione G. Pascale", Napoli, Italy
| | - Ilaria Calabrese
- Department of Clinical Medicine and Surgery, Federico II University, Napoli, Italy
| | - Serena Cubisino
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori—IRCCS "Fondazione G. Pascale", Napoli, Italy
| | - Luca Falzone
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori—IRCCS "Fondazione G. Pascale", Napoli, Italy
| | - Luigina Poletto
- Cancer Epidemiology Unit, National Cancer Institute Centro di Riferimento Oncologico, IRCCS, Aviano, Italy
| | - Valentina Martinuzzo
- Cancer Epidemiology Unit, National Cancer Institute Centro di Riferimento Oncologico, IRCCS, Aviano, Italy
| | - Melania Prete
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori—IRCCS "Fondazione G. Pascale", Napoli, Italy
| | - Nadia Esindi
- School of Life and Environmental Sciences and Charles Perkins Centre, University of Sydney, Sydney, Australia
| | | | - Daniela Cianniello
- Division of Breast Oncology, Istituto Nazionale Tumori—IRCCS "Fondazione G. Pascale", Napoli, Italy
| | - Monica Pinto
- Rehabilitation Medicine Unit, Istituto Nazionale Tumori—IRCCS "Fondazione G. Pascale", Napoli, Italy
| | - Michelino De Laurentiis
- Division of Breast Oncology, Istituto Nazionale Tumori—IRCCS "Fondazione G. Pascale", Napoli, Italy
| | - Carmen Pacilio
- Division of Breast Oncology, Istituto Nazionale Tumori—IRCCS "Fondazione G. Pascale", Napoli, Italy
| | - Massimo Rinaldo
- Division of Breast Oncology, Istituto Nazionale Tumori—IRCCS "Fondazione G. Pascale", Napoli, Italy
| | | | - Diego Serraino
- Cancer Epidemiology Unit, National Cancer Institute Centro di Riferimento Oncologico, IRCCS, Aviano, Italy
| | - Samuele Massarut
- Division of Breast Cancer Surgery, Centro di Riferimento Oncologico, IRCCS, Aviano, Italy
| | - Chiara Evangelista
- Cancer Epidemiology Unit, National Cancer Institute Centro di Riferimento Oncologico, IRCCS, Aviano, Italy
| | - Agostino Steffan
- Immunopathology and Cancer Biomarkers Unit, National Cancer Institute Centro di Riferimento Oncologico IRCCS, Aviano, Italy
| | | | | | | | | | | | | | | | | | | | - Gabriele Riccardi
- Department of Clinical Medicine and Surgery, Federico II University, Napoli, Italy
| | - Davide Gatti
- Rheumatology Unit, University of Verona, Verona, Italy
| | - David J. A. Jenkins
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, ON, Canada
- Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, Ontario, ON, Canada
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, ON, Canada
| | - Anita Minopoli
- Laboratory Medicine Unit, Istituto Nazionale Tumori—IRCCS "Fondazione G. Pascale", Napoli, Italy
| | - Bruna Grilli
- Laboratory Medicine Unit, Istituto Nazionale Tumori—IRCCS "Fondazione G. Pascale", Napoli, Italy
| | - Ernesta Cavalcanti
- Laboratory Medicine Unit, Istituto Nazionale Tumori—IRCCS "Fondazione G. Pascale", Napoli, Italy
| | - Egidio Celentano
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori—IRCCS "Fondazione G. Pascale", Napoli, Italy
| | - Gerardo Botti
- Scientific Directorate, Istituto Nazionale Tumori—IRCCS "Fondazione G. Pascale", Napoli, Italy
| | - Maurizio Montella
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori—IRCCS "Fondazione G. Pascale", Napoli, Italy
| | - Livia S. A. Augustin
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori—IRCCS "Fondazione G. Pascale", Napoli, Italy
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26
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Vasbinder A, Reding KW, Wang D, Han CJ, Zaslavsky O, Langford D, Cespedes Feliciano EM, Barrington WE, Paskett ED. Postdiagnosis Physical Activity: Association With Long-Term Fatigue and Sleep Disturbance in Older Adult Breast Cancer Survivors. Clin J Oncol Nurs 2020; 24:381-391. [PMID: 32678375 DOI: 10.1188/20.cjon.381-391] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND Physical activity is frequently proposed as an intervention to reduce fatigue and sleep disturbance in cancer survivors; however, the long-term effects of physical activity are often not reported, and older adults are typically excluded from these intervention studies. OBJECTIVES This article aimed to examine if postdiagnosis physical activity is associated with lower long-term fatigue and sleep disturbance in older adult breast cancer survivors. METHODS Data were analyzed of a prospective cohort of 440 breast cancer survivors aged 65 years or older from the Women's Health Initiative study. Multiple linear and logistic regression models were used to examine associations of physical activity with fatigue and sleep disturbance. FINDINGS Higher postdiagnosis physical activity was associated with lower long-term fatigue but was not associated with lower sleep disturbance after adjusting for demographics, cancer characteristics, and baseline measures.
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27
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Moon SY, Jerng UM, Kwon OJ, Jung SY, Lee JY, Yoon SW, Shin WC, Byun JI, Lee JH. Comparative Effectiveness of Cheonwangbosimdan (Tian Wang Bu Xin Dan) Versus Cognitive-Behavioral Therapy for Insomnia in Cancer Patients: A Randomized, Controlled, Open-Label, Parallel-Group, Pilot Trial. Integr Cancer Ther 2020; 19:1534735420935643. [PMID: 32627605 PMCID: PMC7338643 DOI: 10.1177/1534735420935643] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Cancer patients have a 2 times higher prevalence of insomnia than healthy
populations and cancer-related insomnia has received minimal attention while
insomnia can aggravate the rehabilitation of cancer patients. Cheonwangbosimdan
is a Korean herbal medicine generally used to relieve sleep deprivation,
however, few studies presented the effects of Cheonwangbosimdan on
cancer-related insomnia. The purpose of study is to examine the feasibility of
Cheonwangbosimdan treatments for cancer patients. Twenty-two participants were
allocated into a Cheonwangbosimdan or cognitive-behavioral therapy for insomnia
(CBT-I) control group by equal number. The intervention group took
Cheonwangbosimdan liquid once in a day and attend visits once a week for 4
weeks. The CBT-I group underwent individualized behavioral therapy 4 times in 4
weeks. The primary outcome is changes in the Insomnia Severity Index (ISI) from
baseline to the end of the trial. Responses to the Pittsburgh Sleep Quality
Index (PSQI), Epworth Sleepiness Scale (ESS), Zung Self-Rating Anxiety Scale
(SAS), Brief Fatigue Inventory (BFI), Euroqol-5 Dimensions-5 Levels (EQ-5D-5L),
and Eastern Cooperative Oncology Group Performance Status (ECOG-PS) were
secondary outcomes used to evaluate the quality of sleep. Outcomes were measured
at a follow-up visit (visit 5) in the fifth week of the trial. There is no
difference between 2 groups, but both groups showed tendency to alleviate cancer
insomnia symptoms. SAS-K showed significant difference between the 2 groups (P
< .001), as treatment group score was highly lowered than control group
score. The study can contribute to more attentive care for insomnia in cancer
patients.
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Affiliation(s)
- Sun-Young Moon
- Korea Institute of Oriental Medicine, Daejeon, Republic of Korea.,University of Science and Technology (UST), Campus of Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Ui Min Jerng
- Sang-ji University Korean Medicine Hospital, Wonju, Republic of Korea
| | - O-Jin Kwon
- Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - So-Young Jung
- Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Jee Young Lee
- Kyung Hee University Hospital at Gangdong, Seoul, Republic of Korea.,Kyung Hee University, Seoul, Republic of Korea
| | - Seong Woo Yoon
- Kyung Hee University Hospital at Gangdong, Seoul, Republic of Korea.,Kyung Hee University, Seoul, Republic of Korea
| | - Won-Chul Shin
- Kyung Hee University Hospital at Gangdong, Seoul, Republic of Korea
| | - Jung-Ick Byun
- Kyung Hee University Hospital at Gangdong, Seoul, Republic of Korea
| | - Jun-Hwan Lee
- Korea Institute of Oriental Medicine, Daejeon, Republic of Korea.,University of Science and Technology (UST), Campus of Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
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28
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Fox RS, Baik SH, McGinty H, Garcia SF, Reid KJ, Bovbjerg K, Fajardo P, Wu LM, Shahabi S, Ong JC, Zee PC, Penedo FJ. Feasibility and Preliminary Efficacy of a Bright Light Intervention in Ovarian and Endometrial Cancer Survivors. Int J Behav Med 2020; 28:83-95. [PMID: 32080797 DOI: 10.1007/s12529-020-09861-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Cancer-related sleep disturbance is common and can adversely affect physical and mental health. Bright light (BL) therapy is a novel intervention that targets sleep by promoting circadian regulation. Emerging evidence suggests BL can improve sleep disturbance, symptom burden, and health-related quality of life in cancer and other populations; however, this research is limited. The present two-phase pilot study assessed the feasibility and preliminary intended effects of BL therapy on sleep in ovarian and endometrial cancer survivors, and explored biologic and chronobiologic factors that may underlie intervention effects. METHODS In phase I, focus groups were conducted with 12 survivors and 9 gynecologic oncology clinicians to evaluate and gather feedback about the proposed study. In phase II, a pilot randomized controlled trial was conducted with 18 ovarian or endometrial cancer survivors who were randomized 1:1 to receive 45 min of BL or dim light (DL) for 4 weeks. Participants wore wrist actigraphs; completed sleep diaries and self-report questionnaires; and provided blood, saliva, and urine samples at baseline (T1), post-intervention (T2), and 3-month follow-up (T3). RESULTS Study procedures were modified according to focus group results. Enrollment, retention, and adherence were all ≥ 80%. Mixed-model ANOVAs demonstrated that the number of nighttime awakenings per actigraphy, and sleep quality and depression per self-report, trended toward improvements in the BL condition compared to the DL condition. These variables improved from T1 to T2 before returning to baseline at T3. Effect sizes were generally medium to large. CONCLUSIONS Study findings suggest that BL therapy is feasible among ovarian and endometrial cancer survivors. It may be an effective, non-pharmacological approach to reduce sleep disturbance and symptom burden in this population.
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Affiliation(s)
- Rina S Fox
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Sharon H Baik
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Heather McGinty
- Department of Psychiatry and Behavioral Health, Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Sofia F Garcia
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Kathryn J Reid
- Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Katrin Bovbjerg
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Precilla Fajardo
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Lisa M Wu
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.,Aarhus Institute of Advanced Studies, Aarhus University, Aarhus, Denmark
| | - Shohreh Shahabi
- Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Jason C Ong
- Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Phyllis C Zee
- Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Frank J Penedo
- Department of Psychology, University of Miami, 5665 Ponce de Leon Boulevard, Flipse Building, 5th Floor, Coral Gables, FL, 33146, USA.
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29
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El Kherchi O, Aquil A, El Khoudri N, Mouallif M, Daghi M, Guerroumi M, Saad EM, Benider A, Jayakumar AR, Elgot A. Anxiety and Depression Comorbidities in Moroccan Patients With Breast Cancer. Front Psychiatry 2020; 11:584907. [PMID: 33510655 PMCID: PMC7835395 DOI: 10.3389/fpsyt.2020.584907] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Accepted: 11/25/2020] [Indexed: 11/23/2022] Open
Abstract
Background: Breast cancer is the leading cause of cancer death in women worldwide with more than 1. 7 million new cases annually. Major advances have been made in the therapeutic management of this condition in many countries. However, neuropsychiatric disorders in patients with breast cancer constitute a significant concern due to their negative impact on patient's life and on the success of therapy itself. Methodology: In this study we aimed to evaluate psychological disorders in a population of 212 Moroccan women treated for breast cancer within the Mohammed VI Center for the Treatment of Cancers of Casablanca. A questionnaire was designed to this end on the basis of different validated scales, including the Hospital Anxiety Depression Scale (HADS), the Pittsburgh Sleep Quality Index (PSQI), and the Body Image Scale (BIS). Results: Data analysis has shown that 69.3% of participants had significant sleep disorders; 87% suffer from an anxiety-depressive syndrome (ADS), and 83.0% had significant body image dissatisfaction. A positive correlation was shown between ADS and both patients' national health insurance coverage and patients or husbands' education. Analysis further revealed that anxiety and depression were negatively correlated with different types of treatment. Similarly, both BIS and PSQI scores were positively associated with anxiety and depression disorders. Conclusion: The present investigation highlights the need to generalize and strengthen the psychological approach of patients treated for breast cancer in Morocco. We anticipate that such a strategy will alleviate suffering and promote therapy success in these patients and will diminish or prevent conjugal and familial impacts of the illness.
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Affiliation(s)
- Ouassil El Kherchi
- Epidemiology and Biomedical Unit, Laboratory of Sciences and Health Technologies, Higher Institute of Health Sciences, Hassan First University of Settat, Settat, Morocco
| | - Amina Aquil
- Epidemiology and Biomedical Unit, Laboratory of Sciences and Health Technologies, Higher Institute of Health Sciences, Hassan First University of Settat, Settat, Morocco
| | - Noureddine El Khoudri
- Epidemiology and Biomedical Unit, Laboratory of Sciences and Health Technologies, Higher Institute of Health Sciences, Hassan First University of Settat, Settat, Morocco
| | - Mustapha Mouallif
- Epidemiology and Biomedical Unit, Laboratory of Sciences and Health Technologies, Higher Institute of Health Sciences, Hassan First University of Settat, Settat, Morocco
| | - Mohamed Daghi
- Epidemiology and Biomedical Unit, Laboratory of Sciences and Health Technologies, Higher Institute of Health Sciences, Hassan First University of Settat, Settat, Morocco
| | - Maroua Guerroumi
- Epidemiology and Biomedical Unit, Laboratory of Sciences and Health Technologies, Higher Institute of Health Sciences, Hassan First University of Settat, Settat, Morocco
| | - El Madani Saad
- Epidemiology and Biomedical Unit, Laboratory of Sciences and Health Technologies, Higher Institute of Health Sciences, Hassan First University of Settat, Settat, Morocco
| | - Abdellatif Benider
- Mohammed VI Center for the Treatment of Cancers, Ibn Rochd University Hospital Center Casablanca, Casablanca, Morocco
| | - Arumugam R Jayakumar
- Neuropathology Research Unit, Miami VA Medical Center and Department of Obstetrics, Gynecology and Reproductive Sciences University of Miami Miller School of Medicine, Miami, FL, United States
| | - Abdeljalil Elgot
- Epidemiology and Biomedical Unit, Laboratory of Sciences and Health Technologies, Higher Institute of Health Sciences, Hassan First University of Settat, Settat, Morocco
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30
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Analyses of the possible anti-tumor effect of yokukansan. J Nat Med 2019; 73:468-479. [PMID: 30739283 DOI: 10.1007/s11418-019-01283-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Accepted: 01/28/2019] [Indexed: 02/08/2023]
Abstract
The Kampo medicine yokukansan (YKS) has a wide variety of properties such as anxiolytic, anti-inflammatory and analgesic effects, and is also thought to regulate tumor suppression. In this study, we investigated the anti-tumor effect of YKS. We used Lewis lung carcinoma (LLC)-bearing mice that were fed food pellets containing YKS and then performed a fecal microbiota analysis, a microarray analysis for microRNAs (miRNAs) and an in vitro anti-tumor assay. The fecal microbiota analysis revealed that treatment with YKS partly reversed changes in the microbiota composition due to LLC implantation. Furthermore, a miRNA array analysis using blood serum showed that treatment with YKS restored the levels of miR-133a-3p/133b-3p, miR-1a-3p and miR-342-3p following LLC implantation to normal levels. A TargetScan analysis revealed that the epidermal growth factor receptor 1 signaling pathway is one of the major target pathways for these miRNAs. Furthermore, treatment with YKS restored the levels of miR-200b-3p and miR-200c-3p, a recognized mediator of cancer progression and controller of emotion, in the hypothalamus of mice bearing LLC. An in vitro assay revealed that a mixture of pachymic acid, saikosaponins a and d and isoliquiritigenin, which are all contained in YKS, exerted direct and additive anti-tumor effects. The present findings constitute novel evidence that YKS may exert an anti-tumor effect by reversing changes in the fecal microbiota and miRNAs circulating in the blood serum and hypothalamus, and the compounds found in YKS could have direct and additive anti-tumor effects.
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31
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MUTO G, ISHII-NAKAMURA R, YOKOYAMA K, KITAMURA F, OMORI Y, SAITO M, ENDO M. Information exchange using a prescribed form and involvement of occupational health nurses promotes occupational physicians to collaborate with attending physicians for supporting workers with illness in Japan. INDUSTRIAL HEALTH 2019; 57:10-21. [PMID: 29269602 PMCID: PMC6363580 DOI: 10.2486/indhealth.2017-0133] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Accepted: 12/11/2017] [Indexed: 06/07/2023]
Abstract
The maintenance of a balance between work and disease treatment is an important issue in Japan. This study explored factors that affect collaboration between occupational physicians (OPs) and attending physicians (APs). A questionnaire was mailed to 1,102 OPs. The questionnaire assessed the demographic characteristics of OPs; their opinions and behaviors related to collaboration, including the exchange of medical information with APs; and the occupational health service system at their establishments. In total, 275 OPs completed the questionnaire (25.0% response rate). Over 80% of respondents believed OPs should collaborate with APs. After adjusting for company size, collaboration ≥10 times/yr (with regard to both returning to work following sick leave and annual health check-ups for employees) was significantly associated with environmental factors, such as the presence of occupational health nurses (odds ratio (OR): 5.56 and 5.01, respectively, p<0.05) and the use of prescribed forms for information exchange (OR: 4.21 and 3.63, respectively, p<0.05) but not with the demographic characteristics of the OPs (p>0.05). The majority of OPs believed that collaboration with APs is important for supporting workers with illnesses. Support systems including prescribed forms of information exchange and occupational health nurses, play pivotal roles in promoting this collaboration.
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Affiliation(s)
- Go MUTO
- Department of Epidemiology and Environmental Health, Juntendo
University Faculty of Medicine, Japan
- Department of Global Health and Population, Harvard T.H. Chan
School of Public Health, USA
| | - Rina ISHII-NAKAMURA
- Department of Epidemiology and Environmental Health, Juntendo
University Faculty of Medicine, Japan
| | - Kazuhito YOKOYAMA
- Department of Epidemiology and Environmental Health, Juntendo
University Faculty of Medicine, Japan
| | - Fumihiko KITAMURA
- Department of Epidemiology and Environmental Health, Juntendo
University Faculty of Medicine, Japan
| | - Yuki OMORI
- Department of Hygiene, Kitasato University School of
Medicine, Japan
| | | | - Motoki ENDO
- Department of Public Health, Tokyo Women’s Medical
University, Japan
- Department of Public Health, Juntendo University Faculty of
Medicine, Japan
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Parajuli S, Tiwari R, Clark DF, Mandelbrot DA, Djamali A, Casey K. Sleep disorders: Serious threats among kidney transplant recipients. Transplant Rev (Orlando) 2019; 33:9-16. [PMID: 30287137 DOI: 10.1016/j.trre.2018.09.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2018] [Revised: 09/17/2018] [Accepted: 09/21/2018] [Indexed: 12/19/2022]
Affiliation(s)
- Sandesh Parajuli
- Division of Nephrology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States.
| | - Rachna Tiwari
- Division of Sleep Medicine, William S. Middleton Memorial Veterans Hospital, Madison, WI, United States
| | - Dana F Clark
- Division of Nephrology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States
| | - Didier A Mandelbrot
- Division of Nephrology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States
| | - Arjang Djamali
- Division of Nephrology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States; Division of Transplant Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States
| | - Kenneth Casey
- Division of Sleep Medicine, William S. Middleton Memorial Veterans Hospital, Madison, WI, United States
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Mercier J, Savard J, Bernard P. Exercise interventions to improve sleep in cancer patients: A systematic review and meta-analysis. Sleep Med Rev 2017; 36:43-56. [DOI: 10.1016/j.smrv.2016.11.001] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Revised: 10/28/2016] [Accepted: 11/01/2016] [Indexed: 12/26/2022]
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Chaoul A, Milbury K, Spelman A, Basen-Engquist K, Hall MH, Wei Q, Shih YCT, Arun B, Valero V, Perkins GH, Babiera GV, Wangyal T, Engle R, Harrison CA, Li Y, Cohen L. Randomized trial of Tibetan yoga in patients with breast cancer undergoing chemotherapy. Cancer 2017; 124:36-45. [PMID: 28940301 DOI: 10.1002/cncr.30938] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Revised: 05/23/2017] [Accepted: 07/11/2017] [Indexed: 11/09/2022]
Abstract
BACKGROUND The current randomized trial examined the effects of a Tibetan yoga program (TYP) versus a stretching program (STP) and usual care (UC) on sleep and fatigue in women with breast cancer who were undergoing chemotherapy. METHODS Women with stage (American Joint Committee on Cancer (AJCC) TNM) I to III breast cancer who were undergoing chemotherapy were randomized to TYP (74 women), STP (68 women), or UC (85 women). Participants in the TYP and STP groups participated in 4 sessions during chemotherapy, followed by 3 booster sessions over the subsequent 6 months, and were encouraged to practice at home. Self-report measures of sleep disturbances (Pittsburgh Sleep Quality Index), fatigue (Brief Fatigue Inventory), and actigraphy were collected at baseline; 1 week after treatment; and at 3, 6, and 12 months. RESULTS There were no group differences noted in total sleep disturbances or fatigue levels over time. However, patients in the TYP group reported fewer daily disturbances 1 week after treatment compared with those in the STP (difference, -0.43; 95% confidence interval [95% CI], -0.82 to -0.04 [P = .03]) and UC (difference, -0.41; 95% CI, -0.77 to -0.05 [P = .02]) groups. Group differences at the other time points were maintained for TYP versus STP. Actigraphy data revealed greater minutes awake after sleep onset for patients in the STP group 1 week after treatment versus those in the TYP (difference, 15.36; 95% CI, 7.25-23.48 [P = .0003]) and UC (difference, 14.48; 95% CI, 7.09-21.87 [P = .0002]) groups. Patients in the TYP group who practiced at least 2 times a week during follow-up reported better Pittsburgh Sleep Quality Index and actigraphy outcomes at 3 months and 6 months after treatment compared with those who did not and better outcomes compared with those in the UC group. CONCLUSIONS Participating in TYP during chemotherapy resulted in modest short-term benefits in sleep quality, with long-term benefits emerging over time for those who practiced TYP at least 2 times a week. Cancer 2018;124:36-45. © 2017 American Cancer Society.
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Affiliation(s)
- Alejandro Chaoul
- Department of Palliative, Rehabilitation, and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Kathrin Milbury
- Department of Palliative, Rehabilitation, and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Amy Spelman
- Department of Palliative, Rehabilitation, and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Karen Basen-Engquist
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Martica H Hall
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Qi Wei
- Department of Palliative, Rehabilitation, and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Ya-Chen Tina Shih
- Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Banu Arun
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Vicente Valero
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - George H Perkins
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Gildy V Babiera
- Department of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | | | - Rosalinda Engle
- Department of Palliative, Rehabilitation, and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Carol A Harrison
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Yisheng Li
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Lorenzo Cohen
- Department of Palliative, Rehabilitation, and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
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Li N, Otomaru T, Taniguchi H. Sleep quality in long-term survivors of head and neck cancer: preliminary findings. Support Care Cancer 2017; 25:3741-3748. [PMID: 28691133 DOI: 10.1007/s00520-017-3804-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2016] [Accepted: 06/22/2017] [Indexed: 11/24/2022]
Abstract
PURPOSE This preliminary study evaluated sleep quality in long-term head and neck cancer survivors, using demographic data and clinical features of the cancers as assessment criteria. In addition, a possible correlation was examined between scores on self-rated questionnaires of sleep quality and assessments of quality of life and oral health status. METHODS Subjects were 77 head and neck cancer survivors. Sleep quality was evaluated using the Pittsburgh Sleep Quality Index and the Epworth Sleepiness Scale. Oral and general health status was assessed using The Oral Health Impact Profile (OHIP-14) and the Short-Form Health Survey (SF-36), respectively, and correlated with clinical parameters. Spearman's correlation coefficients were calculated to examine relationships between variables. Logistic regression analysis was performed to identify independent variables associated with poor sleep quality. RESULTS Eighty-three percent of patients had poor sleep quality (global scores ≥5) and 40% had a global Pittsburgh Sleep Quality Index score ≥8, indicating significantly poor sleep quality. Nocturnal enuresis, daytime sleepiness, and early morning awakening were the most common complaints. Extensive neck dissection, a lower SF-36 mental component score, and a higher OHIP-14 psychological disability score were independently associated with poor sleep quality. OHIP-14 global score was linked independently with daytime sleepiness. CONCLUSION This is the first study to demonstrate a high prevalence of poor sleep quality in long-term head and neck cancer survivors. Extensive neck dissection, poor mental health, and psychological disability may contribute to poor sleep quality. Maintaining good oral health-related quality of life could promote better sleep in these patients.
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Affiliation(s)
- Na Li
- Department of Maxillofacial Prosthetics, Graduate School, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan
| | - Takafumi Otomaru
- Department of Maxillofacial Prosthetics, Graduate School, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan.
| | - Hisashi Taniguchi
- Department of Maxillofacial Prosthetics, Graduate School, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan
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Evans BJ, Phillips KM, Gonzalez BD, Apte S, Small BJ, Jacobsen PB, Jim HSL. Psychosocial resources and sleep disturbance before chemotherapy for gynecologic cancer. J Psychosoc Oncol 2016; 34:60-76. [PMID: 26771556 DOI: 10.1080/07347332.2015.1128507] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Personal psychosocial resources (e.g., positive affect, social support, perceived mastery, meaning in life) are associated with better sleep in noncancer populations, but there have been few studies in cancer patients. The present study examined psychosocial resources and sleep in gynecological cancer patients. Before chemotherapy, 72 participants completed self-report measures of sleep and psychosocial resources; 63 also completed actigraphic monitoring. Subjective sleep was associated with positive affect, social support, perceived mastery, and meaning in life; objective sleep was associated with social support. Future studies should examine whether interventions to enhance psychosocial resources result in improved sleep in this population.
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Abstract
Sleep-wake cycle disturbances are prevalent in patients with medical conditions and frequently present as part of a symptom cluster. Sleep disturbances impair functioning and quality of life, decrease adherence to treatments of the primary medical condition, and increase morbidity and mortality. The pathophysiology of sleep disturbances in these patients involves alterations in immune and neuroendocrine function and shares common pathophysiologic pathways with comorbidities such as fatigue and depression. Emphasis is placed on the evaluation and management of medical and psychiatric comorbidities and other factors contributing to sleep problems. Primary treatments include cognitive-behavioral therapy and pharmacotherapy.
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Affiliation(s)
- Jayesh Kamath
- Department of Psychiatry, University of Connecticut School of Medicine, 263 Farmington Avenue, Farmington, CT 06030-6415, USA.
| | - Galina Prpich
- Department of Psychiatry, University of Connecticut School of Medicine, 263 Farmington Avenue, Farmington, CT 06030-6415, USA
| | - Sarah Jillani
- Department of Psychiatry, University of Connecticut School of Medicine, 263 Farmington Avenue, Farmington, CT 06030-6415, USA
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Berrett-Abebe J, Cadet T, Pirl W, Lennes I. Exploring the relationship between fear of cancer recurrence and sleep quality in cancer survivors. J Psychosoc Oncol 2015; 33:297-309. [PMID: 25751193 DOI: 10.1080/07347332.2015.1020586] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Fear of cancer recurrence (FCR) and sleep disturbance are identified as top psychosocial concerns in cancer survivorship, yet few studies have explored the association between these two factors. Using data from a study of 67 cancer survivors, hierarchical logistic regression models examined the relationships between socio-demographic characteristics, FCR, and sleep disturbance. More than half of survivors reported poor sleep quality; those with some college education and those with higher levels of FCR were at greater risk for poor sleep. These findings provide formative data for oncology social workers to implement interventions that target FCR as a strategy for improving sleep.
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Affiliation(s)
- Julie Berrett-Abebe
- a School of Social Work, Simmons College, Boston , MA , USA ; and Massachusetts General Hospital Cancer Center , Boston , MA , USA
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Nwachukwu CR, Youland RS, Chioreso C, Wetjen N, NageswaraRao A, Keating G, Laack NN. Health related quality of life (HRQOL) in long-term survivors of pediatric low grade gliomas (LGGs). J Neurooncol 2014; 121:599-607. [PMID: 25467557 DOI: 10.1007/s11060-014-1673-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2014] [Accepted: 11/23/2014] [Indexed: 12/28/2022]
Abstract
The purpose of this study was to assess the health-related quality of life (HRQOL) and the impact of treatment on HRQOL in long-term survivors of pediatric low-grade gliomas (LGGs) using an adult instrument. QOL of 121 patients with a diagnosis of LGG from the Mayo Clinic were assessed using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC-QLQ-C30 for cancer in general) and (EORTC QLQ-BN20 specific for brain tumors). Median follow-up was 21.9 years for the participants. Median age at diagnosis was 11.8 years and at assessment was 33 years. Mean (standard deviation) global QOL score for the study was 78 (18) and 76.4 (22.8) in a reference population of healthy adults. Using QLQ-C30, radiation treated patients compared to non-radiation patients reported lower physical functioning (p = 0.002), role functioning (p = 0.004), and more constipation problems (p < 0.001). Patients with tumor recurrence reported lower role functioning (p = 0.016), social functioning (p = 0.040), and more financial problems (p = 0.029) compared to their counterparts. Using QLQ-BN20, patients with deep tumors compared to cortical tumors reported more bladder control problems (p = 0.016). Radiation treated patients also reported more bladder control problems (p < 0.001) compared to their counterparts. In the multivariable analysis, radiation therapy remained an independent predictor of physical and role functioning as well as symptoms related to brain tumors like visual disorders and motor dysfunction. Global QOL of long-term survivors of pediatric LGGs is similar to that of a reference population of healthy adults. The following tumor and treatment related factors were most consistently associated with poorer QOL: CNS tumor location, post-operative radiation, and tumor recurrence. Future studies are necessary to identify strategies to improve QOL in this subgroup of patients.
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Affiliation(s)
- Chika R Nwachukwu
- Mayo Medical School, College of Medicine, Mayo Clinic, Rochester, MN, USA
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Assessment of sleep disturbance in lung cancer patients: Relationship between sleep disturbance and pain, fatigue, quality of life, and psychological distress. Palliat Support Care 2014; 13:575-81. [DOI: 10.1017/s1478951513001119] [Citation(s) in RCA: 73] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractObjective:We investigated the prevalence of sleep disturbance and psychological distress in lung cancer patients. We also examined the association between sleep disturbance and psychological distress, pain, fatigue, and quality of life in the same population.Method:Fifty lung cancer patients were evaluated. Sleep disturbance was assessed using the Athens Sleep Insomnia Scale (AIS) and psychological distress using the Hospital Anxiety and Depression Scale (HADS). Quality of life (QOL), pain, and fatigue were assessed employing the European Organization of Research and Treatment Quality of Life Questionnaire–Cancer 30 (EORTC QLQ–C30).Results:We observed that 56% of lung cancer patients had sleep disturbance (AIS score ≥6) and 60% had psychological distress (total HADS score ≥11). Patients with sleep disturbance had a HADS score of 14.6 ± 5.8, a fatigue score of 45.3 ± 22.0, and a pain score of 27.2 ± 26.2. In contrast, patients without sleep disturbance had a lower HADS score of 9.9 ± 8.1 (p < 0.05) and a higher fatigue score of 28.5 ± 18.0 (p < 0.01) and a pain score of 8.7 ± 15.8 (p < 0.01). In addition, we found a lower QOL in patients with sleep disturbance (46.3 ± 20.2) than in those without (65.2 ± 20.7) (p < 0.05). We also observed a significant correlation between the AIS, HADS, fatigue, QOL, and pain scores.Significance of Results:Lung cancer patients suffered from combined symptoms related to sleep. Sleeping pills improved sleep induction but were not sufficient to provide sleep quality and prevent daytime dysfunction. Daytime dysfunction was specifically associated with psychological distress. Additionally, the type of sleep disturbance was related to other patient factors, including whether or not they received chemotherapy.
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Update on the role of melatonin in the prevention of cancer tumorigenesis and in the management of cancer correlates, such as sleep-wake and mood disturbances: review and remarks. Aging Clin Exp Res 2013; 25:499-510. [PMID: 24046037 PMCID: PMC3788186 DOI: 10.1007/s40520-013-0118-6] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2013] [Accepted: 04/24/2013] [Indexed: 01/24/2023]
Abstract
The aim of this article was to perform a systematic review on the role of melatonin in the prevention of cancer tumorigenesis--in vivo and in vitro--as well as in the management of cancer correlates, such as sleep-wake and mood disturbances. The International Agency for Research on Cancer recently classified "shift-work that involves circadian disruption" as "probably carcinogenic to humans" (Group 2A) based on "limited evidence in humans for the carcinogenicity of shift-work that involves night-work", and "sufficient evidence in experimental animals for the carcinogenicity of light during the daily dark period (biological night)". The clinical implications and the potential uses of melatonin in terms of biologic clock influence (e.g. sleep and mood), immune function, cancer initiation and growth, as well as the correlation between melatonin levels and cancer risk, are hereinafter recorded and summarized. Additionally, this paper includes a description of the newly discovered effects that melatonin has on the management of sleep-wake and mood disturbances as well as with regard to cancer patients' life quality. In cancer patients depression and insomnia are frequent and serious comorbid conditions which definitely require a special attention. The data presented in this review encourage the performance of new clinical trials to investigate the possible use of melatonin in cancer patients suffering from sleep-wake and mood disturbances, also considering that melatonin registered a low toxicity in cancer patients.
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Hsieh CI, Lung AL, Chang LI, Sampselle CM, Lin CC, Liao YM. Prevalence, associated factors, and relationship to quality of life of lower urinary tract symptoms: a cross-sectional, questionnaire survey of cancer patients. Int J Clin Pract 2013; 67:566-75. [PMID: 23679908 DOI: 10.1111/ijcp.12141] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2012] [Accepted: 01/25/2013] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Few studies conducted outside of Asia have shown that lower urinary tract symptoms (LUTS) could be a concern for cancer patients. This gap necessitates more research on LUTS among cancer patients in Asia, particularly regarding associated factors and the relationship between quality of life and LUTS. OBJECTIVES This study investigates the prevalence, associated factors, and relationship to quality of life of LUTS based on a sample of cancer patients. DESIGN A cross-sectional, questionnaire survey. SETTINGS/PARTICIPANTS This study was conducted at two oncology outpatient departments in two hospitals in Taiwan, and included 134 Asian cancer patients. METHODS We collected information about each participant's individual characteristics, personal habits, LUTS, and quality of life by using a questionnaire. We calculated descriptive statistics to demonstrate the distribution of collected information, and used multivariate logistic regression to identify the factors associated with LUTS. We used Student's t-test to compare the mean quality of life scores for participants with and without LUTS. RESULTS Ninety-nine (73.9%) participants experienced at least one type of LUTS, and the prevalence rates for various types of LUTS ranged from 3.7% to 52.2%. Radiotherapy and the time since the diagnosis of cancer were associated with LUTS. Participants with LUTS reported lower quality of life scores than participants without LUTS. CONCLUSIONS The high prevalence of LUTS suggests that cancer treatment might be linked to LUTS, which in turn has a negative effect on a patient's quality of life. These results suggest that future research should involve studies in larger, more homogeneous samples. Health care providers should monitor the presence of LUTS and deliver the management and treatments of LUTS to optimise cancer patients' quality of life.
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Affiliation(s)
- C-I Hsieh
- Department of Internal Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
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Trudel-Fitzgerald C, Savard J, Ivers H. Evolution of cancer-related symptoms over an 18-month period. J Pain Symptom Manage 2013; 45:1007-18. [PMID: 23017613 DOI: 10.1016/j.jpainsymman.2012.06.009] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2012] [Revised: 05/21/2012] [Accepted: 06/03/2012] [Indexed: 02/02/2023]
Abstract
CONTEXT Previous studies have revealed inconsistent findings about the longitudinal evolution of cancer-related symptoms. In addition, the contribution of medical factors (e.g., cancer site, and treatments) in explaining the changes in these symptoms is yet to be established. OBJECTIVES This prospective study investigated longitudinal changes of five symptoms (i.e., depression, anxiety, insomnia, fatigue, and pain) in patients scheduled to undergo surgery for cancer (N=828). METHODS The patients completed the Hospital Anxiety and Depression Scale, the Insomnia Severity Index, the Multidimensional Fatigue Inventory, and a pain questionnaire at baseline and after 2, 6, 10, 14 and 18 months. RESULTS Several time changes were statistically significant but effect sizes only revealed one change of a medium magnitude, that is, a reduction of anxiety from T1 to T2 (d=-0.58). Women with breast or gynecological cancer were the only subgroups to exhibit significant changes (i.e., reduction of a small magnitude of anxiety symptoms from T1 to T2; ds=-0.27 and -0.30, respectively). However, numerous differences were found across adjuvant treatments, including greater variations in depression and insomnia scores in the chemotherapy group (ds=-0.71 to 0.20) and a transient increase in fatigue symptoms in patients receiving "all" adjuvant treatments (ds=-0.24 to 0.37). CONCLUSION The severity of cancer-related symptoms varies during the cancer care trajectory, especially anxiety scores, which importantly decrease during the first few months after the surgery. This study also suggests that treatment regimens better account for individual differences than cancer site in the evolution of symptoms.
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Affiliation(s)
- Claudia Trudel-Fitzgerald
- School of Psychology, Université Laval and Laval University Cancer Research Center, Québec, Québec, Canada
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Clevenger L, Schrepf A, Christensen D, DeGeest K, Bender D, Ahmed A, Goodheart MJ, Penedo F, Lubaroff DM, Sood AK, Lutgendorf SK. Sleep disturbance, cytokines, and fatigue in women with ovarian cancer. Brain Behav Immun 2012; 26:1037-44. [PMID: 22543257 PMCID: PMC3434312 DOI: 10.1016/j.bbi.2012.04.003] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2011] [Revised: 03/22/2012] [Accepted: 04/10/2012] [Indexed: 12/13/2022] Open
Abstract
Pro-inflammatory cytokines, such as interleukin-6 (IL-6), have been implicated in the underlying processes contributing to sleep regulation and fatigue. Despite evidence for sleep difficulties, fatigue, and elevations in IL-6 among women with ovarian cancer, the association between these symptoms and IL-6 has not been investigated. To address this knowledge gap, we examined relationships between sleep disturbance, fatigue, and plasma IL-6 in 136 women with ovarian cancer prior to surgery. These relationships were also examined in 63 of these women who were disease-free and not receiving chemotherapy one year post-diagnosis. At both time-points, higher levels of IL-6 were significantly associated with sleep disturbances (p<0.05), controlling for potentially confounding biological and psychosocial covariates. Higher IL-6 was significantly associated with fatigue prior to surgery (p<0.05); however, when sleep disturbance was included in the model, the relationship was no longer significant. IL-6 was not significantly associated with fatigue at one year. Changes in sleep over time were significantly associated with percent change in IL-6 from pre-surgery to one year, adjusting for covariates (p<0.05). These findings support a direct association of IL-6 with sleep disturbances in this population, whereas the relationship between IL-6 and fatigue prior to surgery may be mediated by poor sleep. As this study is the first to examine cytokine contributions to sleep and fatigue in ovarian cancer, further research is warranted to clarify the role of biological correlates of sleep and fatigue in this population.
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Affiliation(s)
| | - Andrew Schrepf
- Department of Psychology, University of Iowa, Iowa City, IA
| | | | - Koen DeGeest
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Iowa, Iowa City, IA
| | - David Bender
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Iowa, Iowa City, IA
| | - Amina Ahmed
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Iowa, Iowa City, IA
| | - Michael J. Goodheart
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Iowa, Iowa City, IA,Holden Comprehensive Cancer Center, University of Iowa, Iowa City, IA
| | - Frank Penedo
- University of Miami and Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL
| | - David M. Lubaroff
- Holden Comprehensive Cancer Center, University of Iowa, Iowa City, IA,Department of Urology, University of Iowa, Iowa City, IA,Department of Microbiology, University of Iowa, Iowa City, IA
| | - Anil K. Sood
- Departments of Gynecologic Oncology and Cancer Biology, University of Texas MD, Anderson Comprehensive Cancer Center, Houston TX
| | - Susan K. Lutgendorf
- Department of Psychology, University of Iowa, Iowa City, IA,Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Iowa, Iowa City, IA,Holden Comprehensive Cancer Center, University of Iowa, Iowa City, IA,Department of Urology, University of Iowa, Iowa City, IA
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Ritterband LM, Bailey ET, Thorndike FP, Lord HR, Farrell-Carnahan L, Baum LD. Initial evaluation of an Internet intervention to improve the sleep of cancer survivors with insomnia. Psychooncology 2012; 21:695-705. [PMID: 21538678 PMCID: PMC3424270 DOI: 10.1002/pon.1969] [Citation(s) in RCA: 195] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2010] [Revised: 02/24/2011] [Accepted: 02/28/2011] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Insomnia is a common complaint among cancer survivors. Fortunately, cognitive-behavioral therapy for insomnia (CBT-I) has been shown to be an effective treatment in this population. However, it is rarely implemented given its limited availability. To address this barrier, we examined the ability of an easily accessible online CBT-I program to improve insomnia symptoms in cancer survivors. METHODS Twenty-eight cancer survivors with insomnia were randomly assigned to either an Internet insomnia intervention (n = 14) or to a waitlist control group (n = 14). The online program, Sleep Healthy Using The Internet, delivers the primary components of CBT-I (sleep restriction, stimulus control, cognitive restructuring, sleep hygiene, and relapse prevention). Pre- and post-assessment data were collected via online questionnaires and daily sleep diaries. RESULTS Participants in the Internet group showed significant improvements at post-assessment compared with those in the control group in overall insomnia severity (F(1,26) = 22.8; p<0.001), sleep efficiency (F(1,24) = 11.45; P = 0.002), sleep onset latency (F(1,24) = 5.18; P = 0.03), soundness of sleep (F(1,24) = 9.34; P = 0.005), restored feeling upon awakening (F(1,24) = 11.95; P = 0.002), and general fatigue (F(1,26) = 13.88; P = 0.001). Although other group × time interactions were not significant, overall adjusted effect sizes for all sleep variables as well as for fatigue, depression, anxiety, and quality of life ranged from small to large. CONCLUSIONS CBT-I delivered through an interactive, individually tailored Internet intervention may be a viable treatment option for cancer survivors experiencing insomnia.
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Affiliation(s)
- Lee M Ritterband
- Department of Psychiatry and Neurobehavioral Sciences, University of Virginia Health System, Charlottesville, VA 22908, USA.
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Liang JA, Sun LM, Muo CH, Sung FC, Chang SN, Kao CH. Non-apnea sleep disorders will increase subsequent liver cancer risk--a nationwide population-based cohort study. Sleep Med 2012; 13:869-74. [PMID: 22503943 DOI: 10.1016/j.sleep.2012.02.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2011] [Revised: 02/13/2012] [Accepted: 02/14/2012] [Indexed: 10/28/2022]
Abstract
INTRODUCTION It is well known that patients with sleep disorders (SD) have an increased risk of cardiovascular disease, diabetes mellitus, obesity, and total mortality. However, little information exists regarding the relationship between non-apnea SD and the risk of cancer. The goal of this study was to determine if any association between SD and malignancy exists in Taiwan. METHODS We used data from the National Health Insurance system of Taiwan to assess this issue. The SD cohort contained 42,351 patients, and each patient was randomly frequency-matched by age and sex with two people from the general population without SD. The Cox's proportional hazard regression analysis was conducted to estimate the effects of SD on cancer risk. RESULTS In patients with SD, the overall risk of developing cancer was significantly higher than in normal healthy subjects (adjusted Hazard ratio [HR]=1.12, 95% confidence interval=1.06-1.18). This held true even when we analyzed males and females separately. In regards to individual types of cancer, the risk for developing liver cancer among patients with SD was significantly higher than in subjects without SD. For breast cancer the risk showed a marginally significant increase. CONCLUSION The nationwide population-based cohort study found Taiwanese patients with SD have a higher risk of developing cancer, particularly liver cancer and, possibly, breast cancer.
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Affiliation(s)
- Ji-An Liang
- Department of Radiation Oncology, China Medical University Hospital, Taichung, Taiwan
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Romito F, Cormio C, Giotta F, Colucci G, Mattioli V. Quality of life, fatigue and depression in Italian long-term breast cancer survivors. Support Care Cancer 2012; 20:2941-8. [PMID: 22399132 DOI: 10.1007/s00520-012-1424-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2011] [Accepted: 02/21/2012] [Indexed: 12/24/2022]
Affiliation(s)
- Francesca Romito
- Experimental Unit of Psychological Oncology, Department of Critical Area and Surgery, National Cancer Center Giovanni Paolo II, Via O. Flacco 65, 70126, Bari, Italy.
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Kotronoulas G, Wengström Y, Kearney N. A critical review of women's sleep-wake patterns in the context of neo-/adjuvant chemotherapy for early-stage breast cancer. Breast 2011; 21:128-41. [PMID: 22192715 DOI: 10.1016/j.breast.2011.12.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2011] [Revised: 11/28/2011] [Accepted: 12/04/2011] [Indexed: 11/29/2022] Open
Abstract
Complaints of poor nocturnal sleep and daytime dysfunction may be frequent among women receiving chemotherapy for breast cancer. A critical review of the literature was conducted, which aimed at summarising and critically analysing findings regarding sleep in women with early-stage breast cancer across neo-/adjuvant chemotherapy treatment. A systematic search of three electronic databases (Medline, CINAHL, EMBASE) was conducted from January 1980 to July 2011. Twenty-one articles reporting on 12 studies were included for analysis based on pre-specified selection criteria. Varying deficits in sleep parameters may be evident in a significant part of this population. Yet, research data are not equally distributed among the different sleep components, or across all major time points throughout chemotherapy. More systematic investigation of the experience of disrupted sleep in this population with longitudinal mixed-methods studies is warranted to ensure that person-tailored and clinically meaningful care is delivered.
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Affiliation(s)
- Grigorios Kotronoulas
- School of Nursing & Midwifery, University of Dundee, 11 Airlie Place, Dundee, DD1 4HJ, UK.
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